氯胺酮治疗难治性癫痫持续状态的研究进展

Research progress of ketamine in refractory status epileptieus

背景难治性癫痫持续状态（refractory status epileptieus，RSE）发病机制不明，具有高致残率和致死率。大量研究发现氯胺酮对RSE具有良好的治疗效果。目的综述RSE发病机制、氯胺酮用于治疗RSE的研究进展以及其副作用的防止策略，为氯胺酮的临床应用提供参考。内容RSE的发病机制主要与γ-氧基丁酸（γ-aminobutyric acid，GABA）受体的变化、谷氨酸（glutamine，Glu）过量释放等有关。氯胺酮复合用药能够安全有效地终止RSE发作。趋向氯胺酮复合用药早期介入RSE的治疗可能改善其结局，其远期应用前景尚需进一步研究。

Backgroud Because the underlying molecular mechanism remains poorly understood, there is no effective treatment for refractory status epileptieus （RSE）. Thus overall mortality for RSE has been reported up to 50%. However, several studies have demonstrated that ketamine could be an effective drug for stopping RSE. Objective To summarize the underlying molecular mechanism of RSE and explore researches of ketamine used in RSE, aiming at providing practical advice for clinical application. Content The molecular mechanism of RSE was attributed to abnormal γ-aminobutyric acid （GABA） receptor or excessive releasing of Glu and so on. Ketamine combined with other antiepileptic drugs could stop RSE safely and effectively. Trend Early application of ketamine combined with other antiepileptic drugs could prove prognosis of RSE and its application prospect should be further studied.