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中华临床医师杂志(电子版) ›› 2019, Vol. 13 ›› Issue (05) : 379 -384. doi: 10.3877/cma.j.issn.1674-0785.2019.05.012

所属专题: 文献

综述

老年患者术后神经认知障碍影响因素的研究进展
黄家慧1, 唐春林2,()   
  1. 1. 511436 广州,广州医科大学
    2. 510095 广州,广州医科大学附属肿瘤医院麻醉科
  • 收稿日期:2019-01-30 出版日期:2019-03-01
  • 通信作者: 唐春林
  • 基金资助:
    广州市科技计划项目基金(201707010380)

Progress in understanding of factors influencing postoperative neurocognitive disorders in elderly patients

Jiahui Huang1, Chunlin Tang2,()   

  1. 1. Guangzhou Medical University, Guangzhou 511436, China
    2. Department of Anesthesiology, the Affiliated Oncologic Hospital of Guangzhou Medical University, Guangzhou 510095, China
  • Received:2019-01-30 Published:2019-03-01
  • Corresponding author: Chunlin Tang
  • About author:
    Corresponding author: Tang Chunlin, Email:
引用本文:

黄家慧, 唐春林. 老年患者术后神经认知障碍影响因素的研究进展[J]. 中华临床医师杂志(电子版), 2019, 13(05): 379-384.

Jiahui Huang, Chunlin Tang. Progress in understanding of factors influencing postoperative neurocognitive disorders in elderly patients[J]. Chinese Journal of Clinicians(Electronic Edition), 2019, 13(05): 379-384.

术后神经认知障碍是老年患者手术和麻醉后常出现的中枢神经系统并发症,是麻醉学和神经科学的研究热点。患者主要表现为认知功能衰减,可影响术后恢复,增加医疗负担。近年来,随着老年患者人数增多,术后神经认知障碍将成为一个严峻的临床及社会问题。本文旨在总结老年患者术后神经认知障碍相关影响因素,为临床和基础研究的实施提供参考,减少老年患者术后神经认知障碍的发生,减轻患者的医疗负担。

Postoperative neurocognitive disorders, a class of common complications of the central nervous system occurring predominantly in elderly patients undergoing surgery and anesthesia, are the focus of research in anesthesiology and neuroscience. The most common clinical manifestation is decline of cognitive function, which prolongs postoperative recovery and increases the medical burden. In recent years, with the increase in the number of senile patients, postoperative neurocognitive disorders have become a serious clinical and social problem. This article aims to summarize the influencing factors of postoperative neurocognitive disorders in senile patients to provide a reference for future clinical and fundamental research, which will be helpful to reduce the occurrence of postoperative neurocognitive disorders and the medical burden of elderly patients.

4
Fong HK, Sands LP, Leung JM. The role of postoperative analgesia in delirium and cognitive decline in elderly patients: a systematic review [J]. Anesth Analg, 2006, 102(1): 1255-1266.
5
Sun X, Lindsay J, Monsein LH, et al. Silent brain injury after cardiac surgery: a review: cognitive dysfunction and magnetic resonance imaging diffusion-weighted imaging findings [J]. J Am Coll Cardiol, 2012, 60(9): 791-797.
6
Avidan MS, Maybrier HR, Abdallah AB, et al. Intraoperative ketamine for prevention of postoperative delirium or pain after major surgery in older adults: an international, multicentre, double-blind, randomised clinical trial [J]. Lancet, 2017, 390(10091): 267-2755.
7
Rudolph JL, Marcantonio ER. Review articles: postoperative delirium: acute change with long-term implications [J]. Anesth Analg, 2011, 112(5): 1202-1211.
8
Huang C, Irwin MG, Wong GTC, et al. Evidence of the impact of systemic inflammation on neuroinflammation from a non-bacterial endotoxin animal model [J]. J Neuroinflammation, 2018, 15(1):147.
9
Fagan AM, Mintun MA, Mach RH, et al. Inverse relation between in vivo amyloid imaging load and cerebrospinal fluid Abeta42 in humans [J]. Ann Neurol, 2006, 59(3): 512-519.
10
Shiao YJ, Su MH, Lin HC, et al. Echinacoside ameliorates the memory impairment and cholinergic deficit induced by amyloid beta peptides via the inhibition of amyloid deposition and toxicology [J]. Food Funct, 2017, 8(6): 2283-2294.
11
Miller EC, Teravskis PJ, Dummer BW, et al. Tau phosphorylation and tau mislocalization mediate soluble Aβ oligomer-induced AMPA glutamate receptor signaling deficits [J]. Eur J Neurosci, 2014, 39(7): 1214-1224.
12
Zhang L, Trushin S, Christensen TA, et al. Differential effect of amyloid beta peptides on mitochondrial axonal trafficking depends on their state of aggregation and binding to the plasma membrane [J]. Neurobiol Dis, 2018, 114: 1-16.
13
Muche A, Bürger S, Arendt T, et al. Hypoxic stress, brain vascular system, and β-amyloid: a primary cell culture study [J]. Nutr Neurosci, 2015, 18(1): 1-11.
14
Kohman RA, Rhodes JS. Neurogenesis, inflammation and behavior [J]. Brain Behav Immun, 2013, 27(1): 22-32.
15
Gubellini P, Picconi B, Di FM, et al. Downstream mechanisms triggered by mitochondrial dysfunction in the basal ganglia: from experimental models to neurodegenerative diseases [J]. Biochim Biophys Acta, 2010, 1802(1): 151-161.
16
Fonken LK, Frank MG, D′Angelo HM, et al. Mycobacterium vaccae immunization protects aged rats from surgery-elicited neuroinflammation and cognitive dysfunction [J]. Neurobiol Aging, 2018, 71(1): 105-114.
17
Erikson K, Ala-Kokko TI, Koskenkari J, et al. Elevated serum S-100β in patients with septic shock is associated with delirium [J]. Acta Anaesthesiol Scand, 2019, 63(1): 69-73.
18
Michetti F, Corvino V, Geloso MC. The S100B protein in biological fluids: more than a lifelong biomarker of brain distress [J]. J Neurochem, 2012, 120(5): 644-659.
19
Bianchi R, Giambanco I, Donato R. S100B/RAGE-dependent activation of microglia via NF-kappaB and AP-1 Co-regulation of COX-2 expression by S100B, IL-1beta and TNF-alpha [J]. Neurobiol Aging, 2010, 31(4): 665-677.
20
Petzold A, Jenkins R, Watt HC, et al. Cerebrospinal fluid S100B correlates with brain atrophy in Alzheimer′s disease [J]. Neurosci Lett, 2003, 336(3): 167-170.
21
Siano G, Varisco M, Caiazza MC, et al. Tau modulates VGluT1 expression [J]. J Mol Biol, 2019, 431(4): 873-884.
22
Sayas CL, Medina M, Cuadros R, et al. Role of tau N-terminal motif in the secretion of human tau by end binding proteins [J]. PLoS One, 2019, 14(1): e0210864.
23
Spillantini MG, Goedert M. Tau pathology and neurodegeneration [J]. Lancet Neurol, 2013, 12(6): 609-622.
24
Santacruz K, Lewis J, Spires T, et al. Tau suppression in a neurodegenerative mouse model improves memory function [J]. Science, 2005, 309(5733): 476-481.
25
Haase C, Stieler JT, Arendt T, et al. Pseudophosphorylation of tau protein alters its ability for self-aggregation [J]. Neurochem, 2004, 88(6): 1509-1520.
26
Stokin GB, Goldstein LS. Axonal transport and Alzheimer′s disease [J]. Annu Rev Biochem, 2006, 75(1): 607-627.
27
Kotekar N, Kuruvilla CS, Murthy V. Post-operative cognitive dysfunction in the elderly: A prospective clinical study [J]. Indian J Anaesth, 2014, 58(3): 263-268.
28
Schenning KJ, Murchison CF, Mattek NC, et al. Sex and genetic differences in postoperative cognitive dysfunction: a longitudinal cohort analysis [J]. Biol Sex Differ, 2019, 10(1): 14.
29
Kuh D, Cooper R, Moore A, et al. Age at menopause and lifetime cognition: Findings from a British birth cohort study [J]. Neurology, 2018, 90(19): e1673-e1681.
30
Shao H, Breitner JC, Whitmer RA, et al. Hormone therapy and Alzheimer disease dementia: new findings from the Cache County Study [J]. Neurology, 2012, 79(18): 1846-1852.
31
Monk TG, Weldon BC, Garvan CW, et al. Predictors of cognitive dysfunction after major noncardiac surgery [J]. Anesthesiology, 2008, 108(1): 18-30.
32
Lucin KM, O′Brien CE, Bieri G, et al. Microglial beclin 1 regulates retromer trafficking and phagocytosis and is impaired in Alzheimer′s disease [J]. Neuron, 2013, 79(5): 873-886.
33
Smith MA, Sayre LM, Monnier VM. Radical ageing in Alzheimer′s disease [J]. Trends Neurosci, 1995, 18(4): 172-176.
1
Evered L, Eckenhoff RG, Ames D, et al. Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery—2018 [J]. Brit J Anaesth, 2018, 121(5): 1005-1012.
2
Rundshagen Ingrid. Postoperative cognitive dysfunction [J]. Dtsch Arztebl Int, 2014, 111(8): 119-125.
3
Merkin A, Borisov I, Shushkevitch A, et al. Difficulties in diagnosing delirium in elderly patients in a general hospita [J]. Asian J Psychiatr, 2014, 9(1): 85-86.
34
Netto MB, de Oliveira Junior AN, Goldim M. Oxidative stress and mitochondrial dysfunction contributes to postoperative cognitive dysfunction in elderly rats [J]. Brain Behav Immun, 2018, 73(1): 661-669.
35
Lachmann G, Feinkohl I, Borchers F, et al. Diabetes, but not hypertension and obesity, is associated with postoperative cognitive dysfunction [J]. Dement Geriatr Cogn Disord, 2018, 46(3/4): 193-206.
36
He X, Long G, Quan C, et al. Insulin resistance predicts postoperative cognitive dysfunction in elderly gastrointestinal patients [J]. Front Aging Neurosci, 2019, 11: 197.
37
Singh-Manoux A, Dugravot A, Shipley M, et al. Obesity trajectories and risk of dementia: 28 years of follow-up in the WhitehallⅡStudy [J]. Alzheimers Dement, 2018, 14(2): 178-186.
38
Wang J, Lu Z, Fu X, et al. Alpha-7 nicotinic receptor signaling pathway participates in the neurogenesis induced by ChAT-positive neurons in the subventricular zone [J]. Transl Stroke Res, 2017, 8(5): 484-493.
39
Cai L, Lu K, Chen X, et al. Auricular vagus nerve stimulation protects against postoperative cognitive dysfunction by attenuating neuroinflammation and neurodegeneration in aged rats [J]. Neurosci Lett, 2019, 703: 104-110.
40
Wang J, Fu X, Zhang D, et al. ChAT-positive neurons participate in subventricular zone neurogenesis after middle cerebral artery occlusion in mice [J]. Behav Brain Res, 2017, 316(Complete): 145-151.
41
Femenía T, Giménez-Cassina A, Codeluppi S, et al. Disrupted neuroglial metabolic coupling after peripheral surgery [J]. J Neurosci, 2018, 38(2): 452-464.
42
Rappold T, Laflam A, Hori D, et al. Evidence of an association between brain cellular injury and cognitive decline after non-cardiac surgery [J]. Brit J Anaesth, 2016, 116(1): 83-89.
43
Chen C, Cai J, Zhang S, et al. Protective effect of RNase on unilateral nephrectomy-induced postoperative cognitive dysfunction in aged mice [J]. PLoS One, 2015, 10(7): e0134307.
44
Jiang XL, Gu XY, Zhou XX, et al. Intestinal dysbacteriosis mediates the reference memory deficit induced by anaesthesia/surgery in aged mice [J]. Brain Behav Immun, 2019, 80: 605-615.
45
Wang WX, Wu Q, Liang S, et al. Dexmedetomidine promotes the recovery of neurogenesis in aged mouse with postoperative cognitive dysfunction [J]. Neurosci Lett, 2018, 677(1): 110-116.
46
Xiong B, Shi Q, Fang H. Dexmedetomidine alleviates postoperative cognitive dysfunction by inhibiting neuron excitation in aged rats [J]. Am J Transl Res, 2016, 8(1): 70-80.
47
Carr ZJ, Cios TJ, Potter KF, et al. Does Dexmedetomidine ameliorate postoperative cognitive dysfunction? A brief review of the recent literature [J]. Curr Neurol Neurosci Rep, 2018, 18(10): 64.
48
Farag E, Chelune GJ, Schubert A, et al. Is depth of anesthesia, as assessed by the Bispectral index, related to postoperative cognitive dysfunction and recovery? [J]. Anesth Analg, 2006, 103(3): 633-640.
49
An J, Fang Q, Huang C, et al. Deeper total intravenous anesthesia reduced the incidence of early postoperative cognitive dysfunction after microvascular decompression for facial spasm [J]. J Neurosurg Anesthesiol, 2011, 23(1): 12-17.
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