手术炎症和术后认知功能障碍关系的研究进展

宋铭 临1, 刘 颖2, 宋晨 浩1, 王宝 忠1
1.华北理工大学；2.河北医科大学

摘要

摘要：术后认知功能障碍(POCD)是一种常见的术后并发症，主要发生在手术和麻醉后的患者。虽然已经对POCD进行了大量研究，但其病理生理机制仍不清楚。神经炎症可促进外周炎症相关因素的释放、血脑屏障的降解和破坏、中枢炎症的发生以及神经元凋亡和突触丧失，这表明炎症机制可能在POCD的发生中发挥关键作用。

关键词

关键词：术后认知功能障碍，炎症

参考

[1]MASHOUR G A, WOODRUM D T, AVIDAN M S. Neurological complications of surgery and anaesthesia[J]. Br J Anaesth, 2015,114(2): 194-203.[2]YANG X, HUANG X, LI M, et al. Identification of individuals at risk for postoperative cognitive dysfunction (POCD)[J]. Ther Adv Neurol Disord, 2022,15: 81571852.[3]FEINKOHL I, WINTERER G, SPIES C D, et al. Cognitive Reserve and the Risk of Postoperative Cognitive Dysfunction[J]. Dtsch Arztebl Int, 2017,114(7): 110-117.[4]PAREDES S, CORTINEZ L, CONTRERAS V, et al. Post-operative cognitive dysfunction at 3 months in adults after non-cardiac surgery: a qualitative systematic review[J]. Acta Anaesthesiol Scand, 2016,60(8): 1043-1058.[5]SILBERT B, EVERED L, SCOTT D A, et al. Preexisting cognitive impairment is associated with postoperative cognitive dysfunction after hip joint replacement surgery[J]. Anesthesiology, 2015,122(6): 1224-1234.[6]EVERED L A, SILBERT B S, SCOTT D A, et al. Prevalence of Dementia 7.5 Years after Coronary Artery Bypass Graft Surgery[J]. Anesthesiology, 2016,125(1): 62-71.[7]SKVARC D R, BERK M, BYRNE L K, et al. Post-Operative Cognitive Dysfunction: An exploration of the inflammatory hypothesis and novel therapies[J]. Neurosci Biobehav Rev, 2018,84: 116-133.[8]BIANCHI M E, CRIPPA M P, MANFREDI A A, et al. High-mobility group box 1 protein orchestrates responses to tissue damage via inflammation, innate and adaptive immunity, and tissue repair[J]. Immunol Rev, 2017,280(1): 74-82.[9]YU H, DONG R, LU Y, et al. Short-Term Postoperative Cognitive Dysfunction and Inflammatory Response in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: A Pilot Study[J]. Mediators Inflamm, 2017,2017: 3605350.[10]LIN G X, WANG T, CHEN M H, et al. Serum high-mobility group box 1 protein correlates with cognitive decline after gastrointestinal surgery[J]. Acta Anaesthesiol Scand, 2014,58(6): 668-674.[11]WAN Y, XU J, MA D, et al. Postoperative impairment of cognitive function in rats: a possible role for cytokine-mediated inflammation in the hippocampus[J]. Anesthesiology, 2007,106(3): 436-443.