肠道菌群发挥整合作用介导术后谵妄的研究进展*

doi:10.3870/j.issn.1672-0741.26.03.019

摘要/Abstract

摘要： 术后谵妄（postoperative delirium,POD）是老年患者术后常见的神经认知障碍,其发病机制尚未完全阐明。研究表明,POD并非由单一病理通路所致,而是术前脆弱脑与围术期应激共同作用的结果,肠道菌群可能参与其中,并通过多层次机制参与POD的发生发展。该文在总结现有实验和临床证据的基础上,提出肠道菌群发挥整合作用,并通过免疫炎症与屏障、菌群来源代谢产物、神经递质以及迷走神经反射等途径参与POD发生发展的机制,同时进一步讨论了肠道菌群靶向策略在 POD 预防和早期干预中的潜在转化价值,为建立机制导向的个体化围术期管理策略提供新思路。

关键词: 术后谵妄, 肠道菌群, 菌群-肠-脑轴

Abstract: Postoperative delirium （POD） is a common neurocognitive disorder in elderly patients after surgery, and its pathogenesis has not yet been fully elucidated. Evidence suggests that POD does not result from a single pathological pathway, but rather from the combined effects of a vulnerable brain predisposed to the condition and perioperative stress. The gut microbiota may be involved in this process and contribute to the onset and progression of POD through multilayered mechanisms. Based on a synthesis of current experimental and clinical evidence, this review proposes that the gut microbiota plays an integrative role in POD, participating in its development through mechanisms involving inflammation, barrier dysfunction, gut microbiota-derived metabolites, neurotransmitters, and vagal reflex pathways. This review also discusses the potential translational value of gut microbiota-targeted strategies for preventing and early intervention for POD. The aim is to provide new insights for developing mechanism-oriented, individualized perioperative management strategies.

Key words: postoperative delirium, gut microbiota, microbiota-gut-brain axis

中图分类号:

R619

刘秋荣, 王瑄, 张杰. 肠道菌群发挥整合作用介导术后谵妄的研究进展^*[J]. 华中科技大学学报（医学版）, 2026, 55(5): 735-741.

Liu Qiurong, Wang Xuan, Zhang Jie. Research Progress on the Integrative Effects of Gut Microbiota in Mediating Postoperative Delirium[J]. Acta Medicinae Universitatis Scientiae et Technologiae Huazhong, 2026, 55(5): 735-741.

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肠道菌群发挥整合作用介导术后谵妄的研究进展^*

Research Progress on the Integrative Effects of Gut Microbiota in Mediating Postoperative Delirium

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