术后认知功能障碍分子机制与麻醉的潜在联系

摘要

背景 术后认知功能障碍(postoperative cognitive dysfunction,POCD)的发病机制多年来倍受关注,其中麻醉因素在POCD相关的多种分子生物学改变中起到了重要作用.目的 将POCD分子机制与麻醉间的潜在关系作一系统综述.内容 近年大量动物实验及体外研究发现,全身麻醉药能引起神经细胞相关蛋白退行性变、调节炎性因子表达、与中枢胆碱能受体相互作用并能在特异条件下产生神经毒性物质,均与POCD相关.趋向 麻醉在POCD中的作用机制尚不明确,需要进一步研究以找到其防治方向.%Background The pathogenesis of postoperative cognitive dysfunction (POCD) has not been clarified for years.Recent studies suggest that anesthesia may play an important role in the multiple molecular changes associated with POCD.Objective To review the potential links between anesthesia and the multifactorial molecular mechanisms of POCD.Content General anesthetics could induce the production of neurodegenerative proteins,regulate the release of inflammatory mediators,interact with central cholinergic receptors and produce neurotoxic materials,which may all promote the occurance and development ofPOCD.Trend The relationship between anesthesia and the development of POCD is ambiguous and further research is needed.