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右美托咪定的器官保护作用及其机制。

Organ-Protective Effects and the Underlying Mechanism of Dexmedetomidine.

机构信息

Department of Anesthesiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, China.

出版信息

Mediators Inflamm. 2020 May 9;2020:6136105. doi: 10.1155/2020/6136105. eCollection 2020.

Abstract

Dexmedetomidine (DEX) is a highly selective 2 adrenergic receptor (2AR) agonist currently used in clinical settings. Because DEX has dose-dependent advantages of sedation, analgesia, antianxiety, inhibition of sympathetic nervous system activity, cardiovascular stabilization, and significant reduction of postoperative delirium and agitation, but does not produce respiratory depression and agitation, it is widely used in clinical anesthesia and ICU departments. In recent years, much clinical study and basic research has confirmed that DEX has a protective effect on a variety of organs, including the nervous system, heart, lungs, kidneys, liver, and small intestine. It acts by reducing the inflammatory response in these organs, activating antiapoptotic signaling pathways which protect cells from damage. Therefore, based on wide clinical application and safety, DEX may become a promising clinical multiorgan protection drug in the future. In this article, we review the physiological effects related to organ protection in 2AR agonists along with the organ-protective effects and mechanisms of DEX to understand their combined application value.

摘要

右美托咪定(DEX)是一种高度选择性的 2 肾上腺素能受体(2AR)激动剂,目前在临床环境中使用。由于 DEX 具有镇静、镇痛、抗焦虑、抑制交感神经系统活性、心血管稳定和显著减少术后谵妄和躁动的剂量依赖性优势,但不产生呼吸抑制和躁动,因此广泛应用于临床麻醉和 ICU 科室。近年来,大量的临床研究和基础研究证实,DEX 对包括神经系统、心脏、肺、肾脏、肝脏和小肠在内的多种器官具有保护作用。它通过减少这些器官中的炎症反应,激活抗凋亡信号通路来保护细胞免受损伤。因此,基于广泛的临床应用和安全性,DEX 可能成为未来有前途的临床多器官保护药物。本文综述了 2AR 激动剂与器官保护相关的生理效应以及 DEX 的器官保护作用及其机制,以了解它们的联合应用价值。

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