糖尿病与吸入性麻醉药心肌保护作用研究新进展

Interference of diabetes on volatile anesthetic-induced myocardial protection

目前研究表明，对于心肌缺血，再灌注（ischemic／reperfusion，I／R）损伤，适当的刺激可以激活机体的内源性保护机制，即缺血预处理（ischemic preconditioning，IPC）和缺血后处理（ischemic postconditioning，I-post），最终达到心肌保护效果。同时现有的研究发现，吸入性麻醉药同样可以诱导产生内源性的心肌保护作用，其作用机制及临床应用前景成为目前广泛关注的焦点，现就以七氟醚为代表的吸入性麻醉药的心肌保护作用及糖尿病与吸入性麻醉药心肌保护作用的关系作一简要综述。

Volatile anesthetic pre- or post-conditioning presents protective effects against ischemic damage of myocardium, by activating endogeneous protection mechanisms. Recent studies show that hyperglycemia may block anesthetic conditioning-induced protective effect, and that volatile anesthetics inhibit insulin release, producing hyperglycemia. Volatile anesthetic-produced myocardial protective effects may have a promising future in clinical application, and more attention should be paid on the relationship between diabetes and myocardial protection of volatile anesthetic.