右美托咪定围术期应用的研究进展

发布时间：2018-05-24 17:49

本文选题：右美托咪定 + 围术期　；参考：《中国药房》2017年05期

【摘要】：目的:了解右美托咪定围术期应用的研究进展。方法:查阅近年来国内外相关文献,对右美托咪定围术期应用的研究进行归纳和总结。结果与结论:右美托咪定通过抑制去甲肾上腺素的释放,减轻神经细胞炎症反应,从而减少创伤后应激障碍、术后谵妄及认知功能障碍的发生,对中枢神经系统具有保护作用;而对外周神经系统的保护效应可能通过超极化激活环核苷酸门控阳离子通道及降低Ih电流发挥作用。右美托咪定可能通过抑制机体炎症反应以降低自然杀伤细胞及T细胞的活性,对机体免疫功能产生影响。右美托咪定抑制炎症反应的机制可能与增强迷走神经的兴奋性和乙酰胆碱的释放,抑制高迁移率蛋白族1/核转录因子/Toll样受体信号通路的激活相关。右美托咪定对肺的保护作用与其抑制p38丝裂原活化蛋白激酶信号通路、上调水通道蛋白表达和抑制促炎因子和炎症介质释放相关。对组织器官缺血再灌注损伤的保护作用主要与右美托咪定抑制氧自由基介导的脂质过氧化反应有关。右美托咪定与麻醉药的相互作用主要表现为协同作用。
[Abstract]:Objective: to study the application of dexmetidine in perioperative period. Methods: the research on the perioperative application of dexmetomidine was summarized and summarized by referring to the relevant literatures at home and abroad in recent years. Results & conclusion: dexmetidine has protective effect on the central nervous system by inhibiting the release of norepinephrine and reducing the inflammatory reaction of nerve cells, thereby reducing post-traumatic stress disorder, postoperative delirium and cognitive dysfunction. The protective effect of peripheral nervous system may play a role through hyperpolarization activation of cyclic nucleotide gated cation channel and reduction of Ih current. Dexmetomidine may affect the immune function of the body by inhibiting the inflammatory response in order to reduce the activity of natural killer cells and T cells. The mechanism of dexmetomidine in inhibiting inflammation may be related to the enhancement of excitability of vagus nerve and the release of acetylcholine and the inhibition of the activation of high mobility protein-1 / nuclear transcription factor / Toll-like receptor signaling pathway. The protective effect of dexmetomidine on lung is related to its inhibition of p38 mitogen-activated protein kinase signaling pathway, up-regulation of aquaporin expression and inhibition of inflammatory factor and inflammatory mediators release. The protective effect of dexmetidine on ischemia-reperfusion injury is related to the inhibition of lipid peroxidation mediated by oxygen free radical. The interaction between dexmetidine and anesthetics is mainly synergistic.
【作者单位】：攀枝花学院附属医院麻醉科;
【基金】：四川省医学科研青年创新课题计划(No.Q15052)
【分类号】：R614

【参考文献】