吸入麻醉药预处理对心肌缺血“第二保护窗”的作用机制

Mechanism of volatile anesthetic preconditioning-induced sion injury

吸入麻醉药预处理对心肌缺血侑罐注损伤具有急性期和“第二保护窗”两个时间段的保护作用。“第二保护窗”起效缓慢而持久，临床上有充分的时间在手术前给予，能更方便有效地预防围术期心肌缺血的并发症。它可诱导一些触发因子如腺苷、一氧化氮的产生，通过信号转导通路蛋白激酶C、核因子-κB等，作用于ATP敏感性钾通道及活性氧族等终末效应离子通道或保护蛋白而发挥迟发性心肌保护。现就近年来关于吸入麻醉药预处理对心肌“第二保护窗”的作用机制作一综述。

Volatile anesthetic preconditioning can elicit acute and delayed （also called as ＂second window＂） myocardial pro- tection, and the latter may be more clinically significant in decreasing the risk of myocardial ischemia/reperfusion injury for patients with cardiovascular disease. The ＂second window＂ protection might be achieved by stimulating myocardium to trigger adenosine and nitric oxide release, passing through protein kinase C and nuclear factor-κB signal transduction pathways, activating the ATP-sensitire potassium channel and reactive oxygen species as the final effectors, presenting a delayed myocardial protective effect. This review summarizes the latest studies about volatile anesthetic preconditioning-induced ＂second window＂ protection.