右美托咪定改善衰弱老年围术期神经认知障碍的机制及研究进展

doi:10.3969/j.issn.1006-5725.2024.17.025

Abstract

Abstract:

With the acceleration of population aging and the continuous growth of the elderly population， frailty has become a global public health problem. At the same time， an increasing number of elderly people require surgical treatment， and people are paying more attention to the possible postoperative neurocognitive disorder. Frailty and neurocognitive disorder interact with each other， forming a vicious cycle. Improving one of them can improve the prognosis of the elderly. As one of the commonly used anesthetic drugs in clinical practice， dexmedetomidine has neuroprotective effects.This article reviews the relationship between frailty and neurocognitive disorder， as well as the research progress of dexmedetomidine in improving perioperative neurocognitive disorder in frail elderly patients.

Key words: dexmedetomidine, frailty, perioperative neurocognitive disorder

CLC Number:

R749.7⁺1

Zhiyan XU,Weiyuan CHEN,Weifeng. YAO. Mechanism and research progress of dexmedetomidine in improving perioperative neurocognitive disorder in frail elderly patients[J]. The Journal of Practical Medicine, 2024, 40(17): 2503-2507.

Figures/Tables 1

References 37

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研究	对象	内容	靶点或通路	PND类型（DEX使用剂量和时间）
WANG， 2021^［23］	18周C57BL/6小鼠	海马	miR-381↑， EGR1/p53 通路↓，海马神经元凋亡↓	POCD↓ （5 μg/kg， 14 d）
SUN， 2020^［24］	9周雄性大鼠（64）	海马	miR-129↑， YAP1/JAG1 通路↑	认知损害↓ （24 h）
ZHOU， 2020^［25］	老年男性，BV2细胞， C57BL/6小鼠（15月）	海马	BV2 细胞和海马中TNF-α↓， IL-1b↓， IL-6↓， TLR4↓， NF-kB↓	POCD↓ （25 μg/kg， 1 d， 3 d，and 7 d）
LI， 2020^［26］	雄性大鼠，RAW264.7， BV2细胞	海马	IL-1β↓，albumin↑，netrin-1↓，LTB4↓， LAB4↓，p65↓	POCD↓
BAO， 2019^［27］	HT22细胞珠	—	HIF-a/PKM2 通路↓， PI3K-AKT 通路↑	凋亡↓（200 μmol/L， 24 h）
XING， 2020^［32］	7天大鼠	海马	PSD95↑， caspase 3↓， Bax↓， miR-34a↓， aPI3K-Akt 通路↑，	（25 μg/kg， 50 μg/kg，75 μg/kg， 2 h）
LI， 2021^［33］	老年病人（120）	血清	Ab↓，IL-1b↓， IL-6↓ and TNF-α↓	POCD↓（0.6 μg/（kg·h）and 0.8 μg/（kg·h）， 1， 3 and 7 d）
CHEN， 2023^［35］	7天大鼠	海马	BDNF↑，BDNF/TrkB/CREB 通路↑	神经元发生（25?μg/kg）↑
ZHAI， 2023^［38］	C57BL/6	小胶质细胞	α2A 肾上腺素能受体↑，C3↓，小胶质细胞吞噬↓	认知缺陷↓ （50 μg/kg 每 2?h，LPS处理后立即使用三倍剂量的DEX）

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Mechanism and research progress of dexmedetomidine in improving perioperative neurocognitive disorder in frail elderly patients

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