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

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【中图分类号】 R651 【文献标志码】 A 【文章编号】 1672-7770（2025）03-0271-07

Abstract： ObjectiveTo investigate the effects long-term high concentration cortisol exposure on cognitive function in patients with Cushing's disease（CD）and the efficacy endoscopic transsphenoidal resection. MethodsA total 1O7 first-time CD patients admitted to the Department Neurosurgery， Hospital from January 2O17 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. ResultsPatients 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.

Key words： Cushing's disease； cognitive function； transsphenoidal surgery

皮质醇作为应激反应中的关键激素，在调节生理和心理应激反应中扮演着至关重要的角色。（剩余9780字）