脑内胰岛素与围术期神经认知障碍相关性的研究进展  

Research progress of brain insulin and perioperative neurocognitive disorder

作　　者：王洁 刘朋[1] WANG Jie;LIU Peng(Department of Anesthesiology,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第三医院麻醉科,石家庄市050051

出　　处：《临床麻醉学杂志》2022年第7期762-766,共5页Journal of Clinical Anesthesiology

摘　　要：围术期神经认知障碍(PND)是老年患者常见的围术期并发症,表现为注意力不集中,学习能力下降和记忆受损,严重影响患者生存质量,增加社会和家庭负担。PND是多种因素共同作用的结果,脑内胰岛素信号通路异常或胰岛素抵抗是PND发生的重要原因之一。脑内胰岛素具有调节能量代谢、促进神经元再生以及改善记忆和认知等作用,其功能失调可能导致老年患者发生认知障碍。麻醉及手术等破坏脑内胰岛素功能,引发神经炎症反应、突触功能受损、β淀粉样蛋白沉积和tau蛋白过度磷酸化等病理变化,最终导致PND。因此,本文就脑内胰岛素对PND的影响进行综述,以期为探究PND的发病机制和寻找新的治疗靶点提供参考。Objective Perioperative neurocognitive disorder(PND)is a common perioperative complication in elderly patients,characterized by inattention,declination of learning capacity and impaired memory,which seriously affects the life quality of patients,as well as increases social and family burdens.PND is the result of joint action of many factors,among which abnormal brain insulin signaling pathway or insulin resistance is one of the important reasons for PND.Brain insulin can regulate energy metabolism,promote neuronal regeneration and improve memory and cognition,and its dysfunction may lead to cognitive impairment in elderly patients.Anesthesia and surgery damage the function of brain insulin,mediating neuroinflammatory reaction,synaptic dysfunction,β-amyloid peptide deposition and tau protein hyperphosphorylation,which in turn leads to PND.Therefore,this paper reviews the effects of brain insulin on PND,in order to provide reference for exploring the pathogenesis of PND and finding new treatment targets.

关 键 词：大脑 胰岛素 围术期神经认知障碍 阿尔茨海默病 鼻内给药 老年 

分 类 号：R749.1[医药卫生—神经病学与精神病学]