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右美托咪定在脑部疾病中的作用机制及神经保护作用的研究进展。

Progress on the Mechanisms and Neuroprotective Benefits of Dexmedetomidine in Brain Diseases.

机构信息

Wuxi Medical School, Jiangnan University, Wuxi, China.

Department of Neurosurgery, Jiangnan University Medical Center, Wuxi, China.

出版信息

Brain Behav. 2024 Nov;14(11):e70116. doi: 10.1002/brb3.70116.

Abstract

INTRODUCTION

Dexmedetomidine, a highly specific α2 agonist, has been extensively utilized in clinical sedation and surgical anesthesia since its introduction in 2000 due to its excellent sympatholytic, sedative, and analgesic effects. This review aimed to identify new approaches for the treatment of patients with brain disorders by thoroughly describing the mechanism of action of dexmedetomidine and examining its neuroprotective effects from the standpoints of basic and clinical research.

METHODS

The PubMed and Web of Science databases were searched using the keywords dexmedetomidine and related brain diseases, although relevant articles from the last decade were included for detailed summarization and analysis.

RESULTS

Dexmedetomidine has shown strong neuroprotective effects, such as protection of the blood-brain barrier, decreased neuronal death, maintained hemodynamic stability, and reduced postoperative agitation and cognitive dysfunction. Furthermore, dexmedetomidine has been shown to exert various neuroprotective effects, including anti-inflammatory and antioxidative stress effects, modulation of autophagy, and reduction of apoptosis in cerebral diseases.

CONCLUSIONS

Dexmedetomidine acts as a neuroprotective agent against brain diseases during all phases of treatment. However, clinical trials with larger sample sizes are required to optimize dosage and dosing strategies.

摘要

简介

自 2000 年上市以来,具有高度特异性的 α2 激动剂右美托咪定因其具有良好的交感神经抑制、镇静和镇痛作用,已广泛应用于临床镇静和手术麻醉。本综述旨在通过详细描述右美托咪定的作用机制,并从基础和临床研究的角度探讨其神经保护作用,为治疗脑疾病患者寻找新方法。

方法

检索 PubMed 和 Web of Science 数据库,使用关键词右美托咪定和相关脑疾病,虽然纳入了过去十年的相关文章进行详细总结和分析。

结果

右美托咪定具有很强的神经保护作用,如保护血脑屏障、减少神经元死亡、维持血流动力学稳定、减少术后躁动和认知功能障碍。此外,右美托咪定还具有抗炎和抗氧化应激、调节自噬和减少脑疾病细胞凋亡等多种神经保护作用。

结论

右美托咪定在治疗的各个阶段都可作为脑疾病的神经保护剂。然而,需要更大样本量的临床试验来优化剂量和给药策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cda/11527817/59accdfcef67/BRB3-14-e70116-g002.jpg

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