右美托咪定肺保护作用及其机制的研究进展
Research Progress of Lung Protective Effect and Mechanism of Dexmedetomidine
DOI: 10.12677/ACM.2021.112095, PDF,   
作者: 孙倩倩, 赵欣荣:延安大学附属医院麻醉与围术期医学科,陕西 延安;白智远:延安大学附属医院老年呼吸科,陕西 延安
关键词: 右美托咪定器官保护作用肺保护机制Dexmedetomidine Organ Protection Effect Lung Protection Mechanism
摘要: 右美托咪定是一种选择性α2肾上腺素受体激动剂,具有镇静、镇痛、抗焦虑等药理作用,因其“可唤醒”的镇静特点及无明显呼吸抑制的优点被广泛用于临床。近年来,随着研究者们对该药的关注,发现其可通过减少细胞凋亡、抑制中性粒细胞聚集、降低气道反应性等多种途径的参与在许多临床情境中均可发挥器官保护作用,其中肺保护作用尤为明显。
Abstract: Dexmedetomidine is a selective alpha 2 adrenergic receptor agonist, it has sedative, analgesic, anti-anxiety and other pharmacological effects. It is widely used in clinical practice due to its “evocative” sedative characteristics and the advantages of no obvious respiratory inhibition. In recent years, with the attention of researchers, it has been found that the drug can play an organ protection role in many clinical situations by reducing apoptosis, inhibiting neutrophil aggregation, reducing airway reactivity and other ways, especially lung protection.
文章引用:孙倩倩, 赵欣荣, 白智远. 右美托咪定肺保护作用及其机制的研究进展[J]. 临床医学进展, 2021, 11(2): 655-661. https://doi.org/10.12677/ACM.2021.112095

参考文献

[1] Hsu, Y.W., Cortinez, L.I., Robertson, K.M., Keifer, J.C., Sum-Ping, S.T., Moretti, E.W., et al. (2004) Dexmedetomidine Pharmacodynamics: Part I: Crossover Comparison of the Respiratory Effects of Dexmedetomidine and Remifentanil in Healthy Volunteers. Anesthesiology, 101, 1066-1076. [Google Scholar] [CrossRef] [PubMed]
[2] Liu, H., Davis, J.R., Wu, Z.L. and Faez Abdelgawad, A. (2017) Dexmedetomidine Attenuates Lipopolysaccharide Induced MCP-1 Expression in Primary Astrocyte. BioMed Research International, 2017, Article ID: 6352159. [Google Scholar] [CrossRef] [PubMed]
[3] Jiang, Y., Xia, M., Huang, Q., Li, Y., Zhang, Z. and Zhang, X. (2019) Protective Effect of Dexmedetomidine against Organ Dysfunction in a Two-Hit Model of Hemorrhage/Resuscitation and Endotoxemia in Rats. Brazilian Journal of Medical and Biological Research, 52, e7905. [Google Scholar] [CrossRef] [PubMed]
[4] Koca, U., Olguner, Ç.G., Ergür, B.U., Altekin, E., Taşdöğen, A., Duru, S., et al. (2013) The Effects of Dexmedetomidine on Secondary Acute Lung and Kidney Injuries in the Rat Model of Intra-Abdominal Sepsis. Scientific World Journal, 2013, Article ID: 292687. [Google Scholar] [CrossRef] [PubMed]
[5] Wu, C.Y., Lu, Y.F., Wang, M.L., Chen, J.-S., Hsu, Y.-C., Yang, F.-S., et al. (2018) Effects of Dexmedetomidine Infusion on Inflammatory Responses and Injury of Lung Tidal Volume Changes during One-Lung Ventilation in Thoracoscopic Surgery: A Randomized Controlled Trial. Mediators of Inflammation, 2018, Article ID: 2575910. [Google Scholar] [CrossRef] [PubMed]
[6] 于健, 李睿, 姚文瑜. 右美托咪啶预处理对下肢缺血再灌注致肺损伤的保护作用[J]. 中华医学杂志, 2014, 94(44): 3510-3514.
[7] Chen, C., Zhang, Z., Chen, K., Zhang, F., Peng, M. and Wang, Y. (2014) Dexmedetomidine Regulates Inflammatory Molecules Contributing to Ventilator-Induced Lung Injury in Dogs. Journal of Surgical Research, 187, 211-218. [Google Scholar] [CrossRef] [PubMed]
[8] 宋思尊, 石明芳. 右美托咪定对ARDS机械通气患儿氧化应激和炎症因子的影响[J]. 中国药师, 2019, 22(9): 1668-1671
[9] 叶强, 黄佳星, 赵其宏. 右美托咪定对ARDS机械通气患者炎症因子及肺损伤的影响[J]. 岭南现代临床外科, 2018, 18(1): 87-89+92.
[10] 李鹏, 陈丹丹, 陈彰强, 程江霞, 秦汉, 李霞, 等. 右美托咪定对撞击性肺损伤大鼠的肺保护作用[J]. 临床麻醉学杂志, 2016, 32(11): 1108-1111.
[11] Liu, X.B., Zhan, H., Zeng, X., Zhang, C.F. and Chen, D.J. (2013) Dexmedetomidine Reduced Cytokine Release during Postpartum Bleeding-Induced Multiple Organ Dysfunction Syndrome in Rats. Mediators of Inflammation, 2013, Article ID: 627831. [Google Scholar] [CrossRef] [PubMed]
[12] Zhang, Q., Wu, D., Yang, Y., Liu, T. and Liu, H. (2015) Effects of Dexmedetomidine on the Protection of Hyperoxia-Induced Lung Injury in Newborn Rats. International Journal of Clinical and Experimental Pathology, 8, 6466-6473.
[13] 朱满桂, 冯艳, 梁敏安, 陈德珠. 右美托咪定在慢性阻塞性肺疾病急性加重期合并呼吸衰竭患者无创正压通气中的应用[J]. 中国医药科学, 2018, 8(23): 27-30.
[14] 李娜. 右美托咪定调控miRNA-146a对COPD肺损伤的保护作用及机制[D]: [博士学位论文]. 广州: 南方医科大学, 2017.
[15] 张震, 徐刚, 邓巧荣, 卢锡华, 李喜龙, 崔亚萍, 等. 右美托咪定预先给药对肝移植术大鼠急性肺损伤时ERK通路的影响[J]. 中华麻醉学杂志, 2016, 36(9): 1089-1093.
[16] Inada, T., Sumi, C., Hirota, K., Shingu, K., Okamoto, A., Matsuo, Y., et al. (2017) Mitigation of Inflammation Using the Intravenous Anesthetic Dexmedetomidine in the Mouse Air Pouch Model. Immunopharmacology and Immunotoxicology, 39, 225-232. [Google Scholar] [CrossRef] [PubMed]
[17] 文春雷, 高鸿, 刘艳秋, 易菁, 赵歆, 雷涓. 右美托咪定对单肺通气患者炎性反应和氧合指数影响的Meta分析[J]. 国际麻醉学与复苏杂志, 2018, 39(1): 39-46.
[18] Hasanin, A., Taha, K., Abdelhamid, B., Abougabal, A., Elsayad, M., Refaie, A., et al. (2018) Evaluation of the Effects of Dexmedetomidine Infusion on Oxygenation and Lung Mechanics in Morbidly Obese Patients with Restrictive Lung Disease. BMC Anesthesiology, 18, Article No. 104. [Google Scholar] [CrossRef] [PubMed]
[19] Yan, X., Cheng, X., Zhou, L., He, X., Zheng, W. and Chen, H. (2017) Dexmedetomidine Alleviates Lipopolysaccharide-Induced Lung Injury in Wistar Rats. Oncotarget, 8, 44410-44417. [Google Scholar] [CrossRef] [PubMed]
[20] 冯树全, 詹英, 张玉坤, 陈军, 杨建平. 右美托咪定后处理对内毒素致大鼠急性肺损伤的影响[J]. 中华麻醉学杂志, 2014, 34(9): 1144-1146.
[21] Wu, Y.Q., Liu, Y.C., Huang, H., Zhu, Y.Z., Zhang, Y., Lu, F.Z., et al. (2013) Dexmedetomidine Inhibits Inflammatory Reaction in Lung Tissues of Septic Rats by Suppressing TLR4/NF-κB Pathway. Mediators of Inflammatio, 2013, Article ID: 562154. [Google Scholar] [CrossRef] [PubMed]
[22] 孔岚, 卢锡华. 右美托咪啶对胸腔镜肺癌根治术患者围手术期炎症反应及细胞免疫功能的影响[J]. 中华医学杂志, 2018, 98(36): 2929-2932.
[23] Bulow, N.M., Colpo, E., Pereira, R.P., Correa, E.F.M., Waczuk, E.P., Duarte, M.F., et al. (2016) Dexmedetomidine Decreases the Inflammatory Response to Myocardial Surgery under Mini-Cardiopulmonary Bypass. Brazilian Journal of Medical and Biological Research, 49, e4646. [Google Scholar] [CrossRef
[24] 张丽丽, 张野, 李云. 右美托咪定对食管癌根治术患者单肺通气时肺组织炎症反应的影响[J]. 中华麻醉学杂志, 2017, 37(2): 147-150.
[25] Zhang, J.R., Lin, Q., Liang, F.Q. and Xie, T. (2019) Dexmedetomidine Attenuates Lung Injury by Promoting Mitochondrial Fission and Oxygen Consumption. Medical Science Monitor, 25, 1848-1856. [Google Scholar] [CrossRef
[26] 路建, 周红梅, 朱志鹏, 杜炎芳, 周清河, 肖旺频. 远隔缺血预处理联合右美托咪定对肺功能不全老年患者开胸围术期肺损伤和术后肺部并发症的影响[J]. 中华老年医学杂志, 2016, 35(4): 381-386.
[27] 雷贤英, 伍长学. 右美托咪定对早期脓毒症大鼠肺水通道蛋白基因表达及炎症因子的影响[J]. 实用医学杂志, 2019, 35(9): 1388-1392.
[28] Groeben, H., Mitzner, W. and Brown, R.H. (2004) Effects of the Alpha2-Adrenoceptor agonist Dexmedetomidine on Bronchoconstriction in Dogs. Anesthesiology, 100, 359-363. [Google Scholar] [CrossRef] [PubMed]
[29] 李娜, 陈小健, 李桂阁, 欧阳碧山, 闫顺昌, 王琳, 等. 右美托咪定对慢性阻塞性肺疾病大鼠机械通气时肺脏氧化应激反应和炎性因子的影响[J]. 中国药业, 2019, 28(17): 19-21.