1.北京大学第三医院麻醉科,北京 100191
2.北京大学第三医院危重医学科,北京 100191
Received:14 February 2026,
Revised:2026-03-29,
Accepted:30 March 2026,
Published:28 May 2026
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王贵芳,韩永正,么改琦.围术期神经认知障碍与肠道菌群:基于微生物-肠-脑轴的研究进展[J].重庆医科大学学报,2026,51(5):730-734.
Wang Guifang,Han Yongzheng,Yao Gaiqi.Perioperative neurocognitive disorders and gut microbiota: research advances based on the microbiota-gut-brain axis[J].Journal of Chongqing Medical University,2026,51(5):730-734.
王贵芳,韩永正,么改琦.围术期神经认知障碍与肠道菌群:基于微生物-肠-脑轴的研究进展[J].重庆医科大学学报,2026,51(5):730-734. DOI: 10.13406/j.cnki.cyxb.004090.
Wang Guifang,Han Yongzheng,Yao Gaiqi.Perioperative neurocognitive disorders and gut microbiota: research advances based on the microbiota-gut-brain axis[J].Journal of Chongqing Medical University,2026,51(5):730-734. DOI: 10.13406/j.cnki.cyxb.004090.
围术期神经认知障碍(perioperative neurocognitive disorders,PND)是老年患者术后常见的中枢神经系统并发症,与住院时间延长、死亡率升高及远期预后不良密切相关,已成为重要的公共卫生问题。PND发病机制复杂,神经炎症、神经递质功能紊乱及血脑屏障损伤等均参与其中。近年来,随着微生物-肠-脑轴研究的深入,肠道菌群在 PND 发生发展中的作用逐渐受到关注。围术期应激可破坏肠道菌群稳态,导致有益菌减少和致病菌增殖,从而通过减少短链脂肪酸等神经保护性代谢产物、增加脂多糖等肠源性炎症介质,激活中枢神经炎症通路并加剧认知功能损害。靶向微生物-肠-脑轴的干预策略可重塑菌群稳态,为PND的预防与治疗提供新方向。本文综述了近年来肠道菌群参与 PND 发生发展的研究进展,并探讨其潜在的临床转化价值。
Perioperative neurocognitive disorders(PND) are a prevalent central nervous system complication after surgery among elderly patients,and are closely associated with prolonged hospitalization,elevated mortality,and compromised long-term outcomes and has thus become an important public health issue. PND has a complex pathogenesis involving neuroinflammation,neurotransmitter dysregulation,and blood-brain barrier impairment. In recent years,with in-depth studies on the microbiota-gut-brain axis,the role of gut microbiota in the development and progression of PND has attracted increasing attention. Perioperative stress disrupts gut microbial homeostasis and results in a depletion of beneficial bacteria and excessive proliferation of pathogenic strains,and such dysbiosis subsequently reduces the synthesis of neuroprotective metabolites(such as short-chain fatty acids) and increases the release of gut-derived inflammatory mediators such as lipopolysaccharide,thereby activating central neuroinflammatory cascades and exacerbating cognitive impairment. Interventions targeting the microbiota-gut-brain axis can restore microbial homeostasis,which provides a new direction for the prevention and treatment of PND. This article summarizes the recent research advances in the role of gut microbiota in the development and progression of PND and discusses its potential value of clinical translation.
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