nav emailalert searchbtn searchbox tablepage yinyongbenwen piczone journalimg journalInfo journalinfonormal searchdiv searchzone qikanlogo popupnotification paper paperNew
2025, 05, v.39 376-380
异氟烷诱发术后谵妄的分子机制:基于网络毒理学与核心靶点的分子对接分析
基金项目(Foundation): 咸阳市重大科研项目(2023-ZD-KY-02); 咸阳市创新能力支撑计划(L2024-CXNL-KJRCTD-KJRC-0016)
邮箱(Email):
DOI: 10.16421/j.cnki.1002-3127.2025.05.005
摘要:

<正>术后谵妄(postoperative delirium,POD)是一种以急性认知功能障碍为特征的术后并发症,在老年患者中发生率高达15%~50%,明显延长住院时间并增加死亡率[1-2]。异氟烷作为吸入麻醉剂,因其诱导迅速、血流动力学稳定等特点,广泛应用于心胸外科、神经外科及老年患者手术。有研究表明,异氟烷麻醉后POD发生率明显高于静脉麻醉(如丙泊酚),尤其在老年群体中[3]。尽管异氟烷麻醉机制已较明确,但其神经毒性及诱发POD的具体分子通路仍不清晰。

Abstract:

KeyWords:
参考文献

[1] Thedim M,Vacas S. Postoperative delirium and the older adult:untangling the confusion[J]. J Neurosurg Anesthesiol,2024,36(3):184-189.

[2] Belrose JC,Noppens RR. Anesthesiology and cognitive impairment:a narrative review of current clinical literature[J]. BMC Anesthesiol,2019,19(1):241.

[3] Callaway JK,Jones NC,Royse CF. Isoflurane induces cognitive deficits in the Morris water maze task in rats[J].Eur J Anaesthesiol,2012,29(5):239-245.

[4] Brosnan RJ. GABA(A)receptor antagonism increases NMDA receptor inhibition by isoflurane at a minimum alveolar concentration[J]. Vet Anaesth Analg,2011,38(3):231-239.

[5] Lor C,Perouansky M,Pearce RA. Isoflurane potentiation of GABA(A)receptors is reduced but not eliminated by the beta3(N265M)Mutation[J]. Int J Mol Sci,2020,21(24):9534.

[6] Vacas S, Cole DJ, Cannesson M. Cognitive decline associated with anesthesia and surgery in older patients[J]. JAMA,2021,326:4773.

[7] Nair AS, Pulipaka K, Rayani BK. Anesthetic-induced developmental neurotoxicity:causes, prospective studies and possible interventions[J]. Med Gas Res,2017,7(3):224-225.

[8] Zhou Z, Ma D. Anaesthetics-induced neurotoxicity in developing brain:an update on preclinical evidence[J].Brain Sci,2014,4(1):136-149.

[9] Gong C, Zhang D, Ou W, et al. Deficiency of mitochondrial functions and peroxidation of frontoparietal cortex enhance isoflurane sensitivity in aging mice[J].Front Aging Neurosci,2020,12:583542.

[10] Palanisamy A. Maternal anesthesia and fetal neurodevelopment[J]. Int J Obstet Anesth,2012,21(2):152-162.

[11] Kraychete DC, Sakata RK, Lannes Lde O, et al.[Postoperative persistent chronic pain:what do we know about prevention,risk factors,and treatment][J]. Rev Bras Anestesiol,2016,66(5):505-512.

[12] Koch S,Blankertz B,Windmann V,et al. Desflurane is risk factor for postoperative delirium in older patients'independent from intraoperative burst suppression duration[J]. Front Aging Neurosci,2023,15:1067268.

[13]王惠芹,陈乃宏.抑郁症发病机制:聚焦蛋白水平与基因异常[J].中华神经科杂志,2023,56(9):1078-1083.

[14] Wang J,Xu H,Wang D,et al. The interactive effect of genetic polymorphisms of IL-10 and COMT on cognitive function in schizophrenia[J]. J Psychiatr Res,2021,136:501-507.

[15] Ghimire LV,Kohli U,Li C,et al. Catecholamine pathway gene variation is associated with norepinephrine and epinephrine concentrations at rest and after exercise[J].Pharmacogenet Genomics,2012,22(4):254-260.

[16] Vasunilashorn SM, Ngo LH, Jones RN, et al. The association between C-reactive protein and postoperative delirium differs by catechol-o-methyltransferase genotype[J]. Am J Geriatr Psychiatry,2019,27(1):1-8.

[17] Yilmaz S, Aksoy E, Diken AI, et al. Dopamine administration is a risk factor for delirium in patients undergoing coronary artery bypass surgery[J]. Heart Lung Circ,2016,25(5):493-498.

[18] Maioli S,Leander K,Nilsson P,et al. Estrogen receptors and the aging brain[J]. Essays Biochem,2021,65(6):913-925.

[19] Piao MH,Liu Y,Wang YS,et al. Volatile anesthetic isoflurane inhibits LTP induction of hippocampal CA1neurons through alpha4beta2 n AChR subtype-mediated mechanisms[J]. Ann Fr Anesth Reanim,2013,32(10):e135-141.

[20] Calsolaro V, Bottari M, Coppini G, et al. Endocrine dysfunction and cognitive impairment[J]. Minerva Endocrinol(Torino),2021,46(3):335-349.

[21] Ma YL,Qin P,Li Y,et al. The effects of different doses of estradiol(E2)on cerebral ischemia in an in vitro model of oxygen and glucose deprivation and reperfusion and in a rat model of middle carotid artery occlusion[J]. BMC Neurosci,2013,14:118.

基本信息:

DOI:10.16421/j.cnki.1002-3127.2025.05.005

中图分类号:R994.3

引用信息:

[1]刘杏,代志明,张元会.异氟烷诱发术后谵妄的分子机制:基于网络毒理学与核心靶点的分子对接分析[J].毒理学杂志,2025,39(05):376-380.DOI:10.16421/j.cnki.1002-3127.2025.05.005.

基金信息:

咸阳市重大科研项目(2023-ZD-KY-02); 咸阳市创新能力支撑计划(L2024-CXNL-KJRCTD-KJRC-0016)

检 索 高级检索

引用

GB/T 7714-2015 格式引文
MLA格式引文
APA格式引文