肠道菌群代谢物与老年手术患者围术期神经认知障碍的研究进展

Research progress on gut microbiota metabolites and perioperative neurocognitive impairment in elderly surgical patients

摘要

我国正不可逆地进入老龄化社会, 由于老年人大脑结构和功能呈现生理性或病理性衰退, 接受麻醉和手术后发生认知障碍已成为老年手术患者术后的常见并发症, 严重影响其术后生活质量与长期预后。 肠道菌群素有人体 “第二大脑” 之称, 其代谢物在机体病理进程中扮演关键角色, 众多研究结果表明, 肠道菌群代谢产物的变化会对认知功能产生影响。 因此, 深入探究肠道菌群代谢物在围术期认知障碍发生发展中的作用, 具有重要的科学意义与临床价值。 现综合分析近年来研究成果, 针对肠道菌群代谢物, 分析其与围术期认知障碍的关联, 期待为临床预防和治疗围术期认知障碍提供参考。

Abstract

China is undergoing an irreversible transition into an aging society. Due to physiological or pathological declines in brain structure and function among the elderly, cognitive impairment after anesthesia and surgery has become a common postoperative complication in older surgical patients, seriously affecting their postoperative quality of life and long-term prognosis. The gut microbiota, often referred to as the “second brain” of the human body, plays a crucial role in pathological processes through its metabolites. Accumulating evidence indicates that alterations in gut microbiota-derived metabolites can influence cognitive function. Therefore, in-depth investigation into the role of gut microbiota metabolites in the development of perioperative cognitive impairment holds significant scientific and clinical value. This review synthesizes recent research findings to analyze the relationship between gut microbiota metabolites and perioperative cognitive impairment, with the aim of providing insights for clinical prevention and treatment strategies.

关键词

老年人 / 肠道微生物群 / 微生物群肠道大脑轴 / 代谢组 / 麻醉 / 术后认知并发症 / 围手术期 / 神经认知障碍

Key words

the elderly / gut microbiota / microbiota-gut-brain axis / metabolome / anesthesia / postoperative cognitive complications / perioperative period / neurocognitive disorders

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基金资助

成都市医学科研课题(2024097)

四川省卫生健康委员会科研课题(18PJ159)