术后认知功能障碍和神经退行:从炎症到精准医学
Xintong Lin1, Yan Luo2, Qianlin Zhu2
1Department of Cell & Systems Biology and Department of Human Biology, University of Toronto, Toronto M5S3G5 / M5S3J6, ON, Canada.
Brain research bulletin
|February 12, 2026
概括
术后认知功能障碍 (POCD) 影响老年手术患者,影响记忆力和注意力. 了解它与神经炎症和阿尔茨海默病的联系,是开发新疗法的关键.
科学领域:
- 神经科学是一个神经科学.
- 老年医学 老年医学
- 麻醉学 麻醉学
背景情况:
- 手术后认知功能障碍 (POCD) 是手术后老年人的常见神经认知问题.
- 它表现为记忆,注意力和执行功能的障碍.
- 在易受影响的个体中,POCD可能会加速神经退行,这凸显了早期检测和干预的必要性.
研究的目的:
- 审查关于POCD机制,风险因素和管理策略的现有证据.
- 探索术前压力和慢性神经退行过程之间的相互作用.
- 为了确定POCD的潜在治疗目标和精准医学方法.
主要方法:
- 对POCD现有的文献进行系统审查.
- 分析神经炎症通路,血脑屏障完整性和类似阿尔茨海默病的病理.
- 评估风险因素,包括年龄,遗传和先前存在的认知状态.
- 评估新兴的药理和非药理干预措施.
主要成果:
- 由细胞因子和微质激活介导的神经炎症是POCD的关键机制.
- 与阿尔茨海默病共享的途径,如粉样β积累和高酸化,都与此有关.
- 高龄,ApoE4基因型和先前的认知能力下降是显著的风险因素.
- 诸如抗炎药物,神经保护剂和特定麻醉技术等干预措施是有前途的.
结论:
- POCD代表了急性手术压力和慢性神经退行症之间的关键联系.
- 对于生物标志物验证和个性化预防策略,需要进一步的研究.
- 长期认知监测对于老年人群中管理POCD至关重要.
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