麻醉药对发育期中枢神经系统影响的研究进展

The effects of anesthetics on developmental central nervous system

背景大量研究发现麻醉药可导致发育期神经细胞变性凋亡，但临床研究中却未能得到确证。目的就麻醉药导致发育期神经细胞变性凋亡及一些改善这些影响的研究进行综述。内容麻醉药如氯胺酮、异氟烷和丙泊酚等可诱发发育期中枢神经系统神经细胞变性、凋亡，由此推测这些药物可能诱发小儿中枢神经细胞变性、凋亡，进而影响预后。最近研究发现，另有麻醉药如氤、右美托咪啶（dexmedetomid，DEX）等能有效地改善上述药物诱导的神经细胞凋亡，这对于优化小儿麻醉用药方案提供了新的思路。趋向进一步的研究趋向可能集中在临床上如何确证麻醉药对发育期神经细胞的影响，并进一步阐明其发生机制。

Background Neuronal cell apoptosis after general anesthesia has recently been documented in many immature animal models, but its study in clinical studies have not been demonstrated. Objective Here, the authors performed a literature review of anesthetics-induced neuroapoptosis and neuroprotection in developmental central nervous system. Content Some commonly used anesthetics, such as ketamine, isoflurane and propofol, can induce neuroapoptosis in developmental central nervous system, which causes great concern when using these anesthetic in pediatrics in clinical practice. Recently, some studies indicated that, xenon and dexmedetomidine （DEX） can reduce anesthetic-induced neuroapoptosis. Trend Further research may tends to confirm whether anesthetics could influence the development of central nervous system in the clinical studies and to elucidate the mechanism of anesthetics-induced neuroapoptosis.