糖尿病患者血糖水平对围术期神经认知障碍的影响  

Effect of Blood Glucose Levels in Diabetic Pa-tients on Perioperative Neurocognitive Dis-orders

作　　者：郭林 张彤 曹兴华[2] 

机构地区：[1]新疆医科大学第四临床医学院,新疆 乌鲁木齐 [2]新疆医科大学附属中医医院麻醉科,新疆 乌鲁木齐

出　　处：《临床医学进展》2023年第11期17160-17165,共6页Advances in Clinical Medicine

摘　　要：围术期神经认知障碍(perioperative neurocognitive disorders, PND)是手术和麻醉公认的神经系统并发症。高龄、教育水平、糖尿病史、围术期血糖控制不佳、麻醉深度等可能是PND的危险因素。关于PND的发生机制尚不明确,而糖尿病患者PND的病理生理机制可能主要与多元醇通路上调和麻醉药物通过中枢神经系统中的胰岛素受体(CNS-IR)影响PI3K/PDK1/AKT信号通路有关。本文对糖尿病患者出现围术期神经认知障碍的研究现状进行综述,从影响因素、发生机制和干预措施等方面进行归纳和分析,旨在为降低糖尿病患者PND发生率以及预防和干预提供参考,提高患者生活质量,改善疾病的预后和加速患者康复。Perioperative neurocognitive disorders (PND) is a major complication of surgery and anesthesia. Advanced age, education level, history of diabetes mellitus, poor perioperative glycemic control, and depth of anesthesia may be risk factors for PND. It is not clear about the mechanism of PND, but the pathophysiological mechanism of PND in diabetic patients may be mainly related to the upreg-ulation of polyol pathway and the influence of narcotic drugs on PI3K/PDK1/AKT signaling pathway through insulin receptors in the central nervous system (CNS-IR). In this paper, we reviewed the current status of research on perioperative neurocognitive disorders in diabetic patients, summa-rized and analyzed multiple aspects such as influencing factors, occurrence mechanisms and inter-ventions, aiming to provide references for preventive interventions to reduce the incidence of PND in diabetic patients, improve the quality of life, improve the prognosis of the disease and accelerate patient recovery after surgery.

关 键 词：围术期神经认知障碍 糖尿病 血糖 糖化血红蛋白 

分 类 号：R58[医药卫生—内分泌]