CAJ | 학술논문

背景术后认知功能障碍(postoperative cognitive dysfunction,POCD)是手术后出现的精神并发症,其发生机制不太清楚,近年来中枢炎症反应机制越来越受到重视. 目的主要综述POCD的中枢炎症发病机制相关研究进展. 内容 POCD好发于老年患者合并代谢综合征、动脉粥样硬化及阿尔茨海默病等人群,而这些人群共有的特点是处于慢性炎症的预激状态;手术创伤虽非病因且是治愈外科疾病的关键,但因外科干预相关的“二次打击”伤害引起的中枢性神经免疫炎症级联放大机制、推进了POCD的发生. 趋向控制围术期神经免疫炎症反应,有助于减少POCD.
배경 술후인지공능장애(postoperative cognitive dysfunction,POCD)시수술후출현적정신병발증,기발생궤제불태청초,근년래중추염증반응궤제월래월수도중시. 목적 주요종술POCD적중추염증발병궤제상관연구진전. 내용 POCD호발우노년환자합병대사종합정、동맥죽양경화급아이자해묵병등인군,이저사인군공유적특점시처우만성염증적예격상태;수술창상수비병인차시치유외과질병적관건,단인외과간예상관적“이차타격”상해인기적중추성신경면역염증급련방대궤제、추진료POCD적발생. 추향 공제위술기신경면역염증반응,유조우감소POCD.
Background Postoperative cognitive dysfunction (POCD) is a serious mental issue after major surgeries,but its mechanism remains unclear.For the past few years,the mechanism of central nervous system inflammation in POCD has caused widespread attention.Objective To reviews the pathogenic role of central nervous system inflammation in POCD.Content Elderly patients with metabolic syndrome,atherosclerosis and Alzheimer's disease are more susceptible to POCD.The common feature in these POCD susceptible patients is chronic inflammation.Surgical trauma itself is not considered to be a disease,but surgical intervention (the "second hit") often lead to the development of systemic inflammatory state and exaggerated neuroimmunoinflammatory response,and facilitate the incidence of POCD at the end.Trend The control of perioperative neuroimmunoinflammatory response may reduce the incidence rate of POCD.