老年髋部骨折患者术后谵妄（POD）发生风险较高，疼痛控制、镇静策略和神经炎症反应都可能影响术后认知结局。 因此，真正需要回答的问题是：右美托咪定联合髋关节囊周围神经群阻滞（PENG）能否减少老年髋部骨折POD？
下面这篇文献将回答这个问题。
文献英文标题
Dexmedetomidine mitigates postoperative delirium after hip fracture surgery in elderly patients by modulating miR-107 expression.
英文摘要要点
Methods: Eighty-four elderly hip fracture patients (July 2022-December 2023) were divided into PENG block group (n = 28), Dex group (n = 27), and combined group (n = 29). NRS, MMSE, and POD incidence (CAM) were evaluated at T0 (preoperative), T1 (postoperative day 1), and T2 (postoperative day 7); serum miR-107 expression was detected and correlated. A mouse POD model and LPS-induced SH-SY5Y cell model were established; Morris water maze, Y-maze, open field test, ROC, logistic, CCK-8, ELISA, qPCR, and dual-luciferase assay were used for mechanism verification.
Results: No significant differences were found among the three groups at T0. At T1 and T2, the combined group had lower NRS scores, higher MMSE scores, lower POD incidence (P < 0.05), and upregulated serum miR-107 (P < 0.001). miR-107 was positively correlated with MMSE (P < 0.001) and negatively correlated with NRS (P < 0.05). Animal/cell experiments showed Dex upregulated miR-107, inhibited FBXW7 and inflammatory factors, and improved cognition; miR-107 directly targeted FBXW7.
Conclusions: Dex combined with PENG block alleviates POD in elderly hip fracture patients by upregulating miR-107 to inhibit FBXW7 and neuroinflammation.
文献标题中文翻译
右美托咪定通过调控微小核糖核酸-107表达缓解老年髋部骨折术后谵妄
文献简介
老年髋部骨折患者POD与疼痛、炎症反应、镇静镇痛药物、基础认知状态和围术期应激等因素有关。右美托咪定具有镇静、镇痛辅助和潜在抗炎作用，PENG则可改善髋部骨折相关疼痛控制。这项研究把临床观察与动物、细胞实验结合，试图解释右美托咪定联合PENG是否能够减少POD，以及微小核糖核酸-107（miR-107）、F盒与WD重复结构域蛋白7（FBXW7）和神经炎症通路可能发挥的作用。