Brainard Jason, Gobel Merit, Bartels Karsten, Scott Benjamin, Koeppen Michael, Eckle Tobias
University of Colorado Denver, Aurora, CO, USA.
University of Colorado Denver, Aurora, CO, USA Ludwig-Maximilians-University, Munich, Germany.
Semin Cardiothorac Vasc Anesth. 2015 Mar;19(1):49-60. doi: 10.1177/1089253214553066. Epub 2014 Oct 7.
The rotation of the earth and associated alternating cycles of light and dark--the basis of our circadian rhythms--are fundamental to human biology and culture. However, it was not until 1971 that researchers first began to describe the molecular mechanisms for the circadian system. During the past few years, groundbreaking research has revealed a multitude of circadian genes affecting a variety of clinical diseases, including diabetes, obesity, sepsis, cardiac ischemia, and sudden cardiac death. Anesthesiologists, in the operating room and intensive care units, manage these diseases on a daily basis as they significantly affect patient outcomes. Intriguingly, sedatives, anesthetics, and the intensive care unit environment have all been shown to disrupt the circadian system in patients. In the current review, we will discuss how newly acquired knowledge of circadian rhythms could lead to changes in clinical practice and new therapeutic concepts.
地球的自转以及与之相关的明暗交替循环——我们昼夜节律的基础——对人类生物学和文化至关重要。然而，直到1971年研究人员才首次开始描述昼夜节律系统的分子机制。在过去几年中，开创性的研究揭示了众多影响多种临床疾病的昼夜节律基因，这些疾病包括糖尿病、肥胖症、败血症、心脏缺血和心源性猝死。麻醉医生在手术室和重症监护病房每天都要应对这些疾病，因为它们会显著影响患者的治疗结果。有趣的是，镇静剂、麻醉剂以及重症监护病房的环境都已被证明会扰乱患者的昼夜节律系统。在本综述中，我们将讨论关于昼夜节律的新认识如何可能导致临床实践的改变和新的治疗理念。
