临床神经外科杂志2025，Vol.22Issue(3)：271-277,7.DOI:10.3969/j.issn.1672-7770.2025.03.006
基于库欣病患者模型的长期高浓度皮质醇暴露对认知功能的影响及内镜经蝶切除术疗效分析
Analysis of impact of long-term high concentration cortisol exposure on cognitive function based on a Cushing's disease patient model and the efficacy of endoscopic transsphenoidal surgery
摘要
Abstract
Objective To investigate the effects of long-term high concentration cortisol exposure on cognitive function in patients with Cushing's disease(CD)and the efficacy of endoscopic transsphenoidal resection.Methods A total of 107 first-time CD patients admitted to the Department of Neurosurgery,Chinese PLA General Hospital from January 2017 to September 2024,as well as 84 age,gender,and education matched healthy controls were included prospectively.All patients received standard surgical treatment.Cognitive function was meticulously evaluated preoperatively and at three months postoperatively using the minimum mental state examination(MMSE)and Montreal cognitive assessment(MoCA)scales by independent assessors,comparing the cognitive improvements between the groups.Results Patients with CD exhibited lower scores on both MMSE and MoCA assessments compared to the health group,particularly in memory,attention and calculation,recall,and language abilities.Following surgery,which alleviated the high cortisol levels,there was a significant enhancement in cognitive function among CD patients.Postoperatively,patients demonstrated increased scores on both MMSE and MoCA,as well as improved performance in all assessed cognitive domains,with notable advancements in memory,attention and calculation,recall,and language.Conclusions Long-term high concentration cortisol exposure significantly impairs cognitive function,and endoscopic transsphenoidal surgery to mitigate this exposure can lead to substantial cognitive improvements.关键词
库欣病/认知功能/内镜经蝶切除术Key words
Cushing's disease/cognitive function/transsphenoidal surgery分类
临床医学引用本文复制引用
许军鹏,彭徐朋,毛之奇,余新光,张艳阳,周涛,王鹏,刘斌,尚国松,冯哲斌,孙宇翔,申浩..基于库欣病患者模型的长期高浓度皮质醇暴露对认知功能的影响及内镜经蝶切除术疗效分析[J].临床神经外科杂志,2025,22(3):271-277,7.基金项目
科技部科技创新2030-"脑科学与类脑研究"重大项目(2021ZD0200407) （2021ZD0200407）
国家自然科学基金资助项目(82001798,81871087) （82001798,81871087）
解放军总医院青年人才项目(20230403) （20230403）
