Minguet G, Brichant J F, Joris J
Department of Anesthesia and Intensive Care Medicine, CHU Liège, University of Liège, B-4000 Liège, Belgium.
Acta Anaesthesiol Belg. 2012;63(1):23-34.
Ischemic preconditioning, first demonstrated in animal myocardium, is an intrinsic and ubiquitous mechanism of marked protection against ischemia. Accumulating evidences have established that endogenous opioid peptides and their receptors play an important role in this adaptive phenomenon in the heart and other major organs. Of interest for therapeutic developments, opioid receptor agonists have been administered successfully to improve tolerance against experimental ischemia-reperfusion in various tissues. Recent human studies now raise the possibility to exploit this opioid-induced protection in clinical cardiac ischemia. These remarkable anti-ischemic properties of opioids and their emerging potential for organ protection in perioperative medicine will be reviewed at the light of pertinent results from basic and clinical researches.
缺血预处理最早在动物心肌中得到证实，是一种针对缺血具有显著保护作用的内在且普遍存在的机制。越来越多的证据表明，内源性阿片肽及其受体在心脏和其他主要器官的这种适应性现象中发挥着重要作用。对于治疗进展而言，阿片受体激动剂已成功用于提高各种组织对实验性缺血再灌注的耐受性。近期的人体研究现在提出了在临床心脏缺血中利用这种阿片类药物诱导的保护作用的可能性。将根据基础研究和临床研究的相关结果，对阿片类药物这些显著的抗缺血特性及其在围手术期医学中新兴的器官保护潜力进行综述。
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