部分全麻药对突触发生期中枢神经系统发育的影响及机制

Effects of some general anesthetics on the development of the central nervous system and their mechanisms

近年的研究表明,在未成熟哺乳动物突触发生期,短暂性拮抗N-甲基-D-天(门)冬氨酸(N-methyl-D-asparate,NMDA)受体或过度激动γ-氨基丁酸A(gamma-amino butyric acid,GABAA)受体可诱发大脑神经细胞的大量凋亡、脊髓凋亡性退变。这些药物主要有全身麻醉药、抗惊厥药及乙醇等。人类突触发生高峰期为妊娠后3个月到出生后3年。妊娠晚期、新生儿及婴幼儿刚好处在这个时间窗,因此该类药物对脑发育的影响成为人们研究的热点,其机制的阐明可能对新生儿、婴幼儿以及孕产妇临床合理用药及新药的开发有指导意义。文中就部分全麻药对突触发生期中枢神经系统发育的影响及机制作一综述。

Recent researches have found that the exposure of the developing mammalians during the period of synaptogenesis to drugs that transiently block N-methyl-D-asparate glutamate receptors or that transiently potentiate gamma-amino butyric acid receptors can trigger widespread apoptotic neurodegeneration in the brains,even in the spinal cords.These drugs include general anesthetics,anticonvulsants,alcohol,etc.The brain growth spurt period,also called synaptogenesis occurs in humans from the third trimester of pregnancy to three years after birth.The time windows include late pregnancy,neonate period and infancy.Therefore,people pay much more attention to the question how these drugs impact the development of the human central nervous system.Elucidation of the mechanisms of some general anesthetics may help the development of new drugs and rational clinical use of the drugs in neonates,infants,and pregnant and parturient women.