PDF(Pubmed)
Abstract：
Postoperative cognitive dysfunction (POCD) is a neurological disorder characterized by the emergence of cognitive impairment after surgery. A growing body of literature suggests that the onset of POCD is closely tied to circadian rhythm disruption (CRD). Circadian rhythms are patterns of behavioral and physiological change that repeat themselves at approximately, but not exactly, every 24 h. They are entrained to the 24 h day by the daily light-dark cycle. Postoperative CRD affects cognitive function likely by disrupting sleep architecture, which in turn provokes a host of pathological processes including neuroinflammation, blood-brain barrier disturbances, and glymphatic pathway dysfunction. Therefore, to address the pathogenesis of POCD it is first necessary to correct the dysregulated circadian rhythms that often occur in surgical patients. This narrative review summarizes the evidence for CRD as a key contributor to POCD and concludes with a brief discussion of how circadian-effective hospital lighting can be employed to re-entrain stable and robust circadian rhythms in surgical patients.
摘要：
术后认知功能障碍（POCD）是一种神经系统疾病，其特征是手术后出现认知障碍。越来越多的文献表明，POCD的发作与昼夜节律中断（CRD）密切相关。昼夜节律是行为和生理变化的模式，但不完全是，每24小时一次。它们被每天的明暗循环夹带到24小时。术后CRD可能通过破坏睡眠结构影响认知功能，这反过来引发了许多病理过程，包括神经炎症，血脑屏障紊乱,和淋巴通路功能障碍。因此,为了解决POCD的发病机制，首先需要纠正经常发生在手术患者中的昼夜节律失调。这篇叙述性综述总结了CRD是POCD的关键贡献者的证据，并最后简要讨论了如何采用昼夜节律有效的医院照明来重新激发手术患者的稳定和稳健的昼夜节律。
