右美托咪定在临床围术期的器官保护作用研究进展

Research Progress of Dexmedetomidine in Organ Protection during Perioperative Period

右美托咪定为一种新型高选择性α_2肾上腺素能受体激动剂,其作用于脑干蓝斑核内的α_2肾上腺素受体产生类似于人自然睡眠状态的镇痛效果。它可以通过减少释放去甲肾上腺素,抑制神经细胞的炎性细胞聚集,减少免疫反应对神经细胞的损伤,降低患者应激障碍、谵妄和认知功能障碍等并发症的发生率。右美托咪定通过提高迷走神经兴奋性和增加乙酰胆碱释放,抑制相关受体信号通路的激活,降低自然杀伤细胞和T细胞的活性,从而调控免疫系统。未来,应对右美托咪定的多器官保护作用机制进行深入研究。

Dexmedetomidine is a novel and highly-selective α2-adrenoceptor agonist which takes an effect on the α2-adrenergic receptors inside brainstem nucleus ceruleus to produce the analgesic effect similar to human＇s natural sleep state. Also, it can reduce the release of norepinephrine to inhibit the inflammatory cell aggregation of nerve cells, reduce the immune reaction damage to nerve cells, reduce the patient＇s stress disorder, delirium and cognitive dysfunction as well as the incidence of other complications. Dexmedetomidine can inhibit the activation of relevant receptor signaling pathway and reduce the activity of natural killer cells and T cells by increasing the excitability of the vagus nerve and the release of acetylcholine, thus regulating immune system. In the future,the mechanism of multiple organ protection of dexmedetomidine should be further studied.