右美托咪定对老年患者围术期神经认知功能障碍的影响

Effect of dexmedetomidine on perioperative neurocognitive disorders in the elderly

围术期神经认知功能障碍是老年患者术后常见的并发症,不仅增加患者住院时间、还会增加经济负担。它的发生可能与无菌手术或麻醉介导的炎症反应、血脑屏障受损、中枢神经系统炎症反应、胶质细胞激活、氧化应激及中枢神经系统相关通路激活和神经递质的释放等因素有关。右美托咪定是一种高选择性α2-肾上腺受体激动剂,自美国食品药品监督管理局批准上市以来被广泛运用临床,且具有心、脑及肾等重要器官保护作用。目前,有报道称对减低围术期认知功能障碍有一定的作用,但未来还需更多的试验以探究其对于认知功能的远期影响。

Perioperative neurocognitive disorders are common postoperative complications in the elderly after surgery,which not only prolong the length of hospital stay but also enhance economic burden.What′s more,their occurrence may be related to inflammatory response,blood-brain barrier damage,central nervous system inflammation,microglia activation,oxidative stress,and activation of central nervous system related pathways and neurotransmitter releaseinduced by aseptic surgery or anesthesia surgery.Dexmedetomidine is a selective alpha 2 adrenal agonists and widely used in clinical practice since being approved by the U.S.Food and Drug Administration,and shows protective effects on important organs such as the heart,brain and kidneys.At present,evidence shows that dexmedetomidine has certain effect on reducing perioperative cognitive impairment,but more researches are needed in the future to explore its long-term impact on cognitive function.