Biomarkers of postoperative delirium and cognitive dysfunction.
Biomarkers of postoperative delirium and cognitive dysfunction.
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DOI：
10.3389/fnagi.2015.00112
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发表时间：
2015
影响因子：
4.8
通讯作者：
Schneider R
中科院分区：
文献类型：
--
作者：
Fournier A;Krause R;Winterer G;Schneider R
老年外科患者经常会出现术后神志不清(POD)和术后认知功能障碍(POCD)。临床特征包括认知恶化、注意力障碍和环境意识降低，导致更高的发病率、死亡率和更多地利用社会经济援助。随着西方社会的老龄化，POD和POCD的发病率有望增加。潜在的病理生理机制已经在分子水平上进行了研究，尽管考虑到它们的社会负担，一些小的研究工作并不令人满意。在这里，我们回顾了已知的生理和免疫变化以及遗传风险因素，确定了进一步研究的候选对象，并将这些信息整合到一个草案网络中，以便在系统水平上进行探索。这些术后认知障碍的发病机制是多因素的；集成系统生物学的应用有可能重建潜在的分子机制网络，并有助于识别预后和诊断生物标记物。
Elderly surgical patients frequently experience postoperative delirium (POD) and the subsequent development of postoperative cognitive dysfunction (POCD). Clinical features include deterioration in cognition, disturbance in attention and reduced awareness of the environment and result in higher morbidity, mortality and greater utilization of social financial assistance. The aging Western societies can expect an increase in the incidence of POD and POCD. The underlying pathophysiological mechanisms have been studied on the molecular level albeit with unsatisfying small research efforts given their societal burden. Here, we review the known physiological and immunological changes and genetic risk factors, identify candidates for further studies and integrate the information into a draft network for exploration on a systems level. The pathogenesis of these postoperative cognitive impairments is multifactorial; application of integrated systems biology has the potential to reconstruct the underlying network of molecular mechanisms and help in the identification of prognostic and diagnostic biomarkers.