不同剂量葡萄糖皮质激素对术后神经认知功能和情绪障碍的影响:系统性审查和网络元分析
Yingying Fan1, Jiaqi Li2, Ruoyu Luo1
1Emergency and Critical Care Center, Department of Medical Education and Simulation Center, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China; School of Nursing, Zhejiang Chinese Medical University, Zhejiang, 310053, China.
Journal of psychiatric research
|October 1, 2025
概括
在外科手术期间使用的葡萄糖皮质类药物显著降低了妄想的发生率和严重程度. 中剂量葡萄糖皮质类药物在预防术后神经认知功能障碍方面表现有前途,提供了更安全的方法.
科学领域:
- 麻醉学 麻醉学
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 手术后神经认知障碍 (PND) 和情绪障碍影响恢复.
- 研究寻求PND和情绪障碍的药理干预措施.
- 葡萄糖皮质类药物在外科手术期间很常见,但它们的神经认知效应仍在争论中.
研究的目的:
- 评估术前葡萄皮质类药物对神经认知和心理结果的影响.
- 评估不同剂量的葡萄糖皮质激素在预防PND和情绪障碍方面的疗效.
主要方法:
- 在PubMed,科克伦图书馆,EMBASE和科学网的综合文献搜索.
- 包括专注于外科手术期间使用皮质类固醇的研究.
- 分析了25项涉及17378名患者的研究.
主要成果:
- 葡萄糖皮质类药物显著降低了术后狂妄症的发生率 (RR=0.85) 和严重程度 (SMD=-0.66).
- 高剂量葡萄糖皮质类药物降低了妄想发病率 (RR=0.79).
- 中剂量葡萄糖皮质类药物降低了术后认知功能障碍 (RR=0.58).
- 葡萄糖皮质类药物没有显著减少情绪障碍的发生 (RR=0.86).
结论:
- 在外科手术期间使用的皮质糖类药物有效地降低了术后妄想的发生率和严重程度.
- 不同的葡萄糖皮质体剂量对神经认知和心理状态产生不同的影响.
- 中剂量的外科皮质糖类药物似乎更安全,可以预防PND.
相关概念视频
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
437
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
437
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
1.5K
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
1.5K
Cognitive Enhancers: Cholinesterase Inhibitors and NMDA Receptor Antagonists
560
Cognitive enhancers, also known as "smart drugs," are substances used to enhance memory, mental alertness, and concentration. These can be natural or synthetic and improve cognition in conditions like Alzheimer's disease (AD) and other neurodegenerative diseases. Some common examples include caffeine, amphetamines, methylphenidate, modafinil, arecoline, donepezil, vortioxetine, and piracetam. These enhancers work on the principle of synaptic plasticity and altered circuit function.
560
Psychosurgery
1.5K
Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...
1.5K
Drugs Affecting Neurotransmitter Synthesis
2.1K
Drugs affecting neurotransmitter synthesis can impact the adrenergic neuron and the synthesis of neurotransmitters. For example, α-methyltyrosine and carbidopa target specific enzymes involved in catecholamine synthesis. α-methyltyrosine inhibits the enzyme tyrosine hydroxylase, which converts tyrosine into dopamine. By blocking this enzyme, α-methyltyrosine reduces dopamine production and other catecholamines. Carbidopa, on the other hand, inhibits the enzyme dopa decarboxylase,...
2.1K

