七氟醚对发育期大脑影响及机制的研究进展

Research advances on mechanisms of sevoflurane-induced developing brain damage

七氟醚是新生儿及儿童麻醉诱导和维持中最常应用的吸入性全身麻醉药,然而大量临床及基础研究指出七氟醚可能对幼儿的大脑发育造成损害.通过查阅相关基础及临床研究资料,文章对七氟醚致小儿发育大脑损伤的临床及基础研究证据,以及可能的Tau蛋白异常磷酸化,氧化应激抑制细胞外信号调节激酶磷酸化,Wnt/β-连环蛋白(β-catenin)信号通路,PERK-eIF2a-ATF4-CHOP信号通路,p53对miRNA-34c的调控等机制进行归纳总结,进一步探究麻醉药对小儿发育期大脑的损伤机制,为临床上寻求相关脑保护措施提供参考.

Sevoflurane is the most commonly used inhalation general anesthetic for induction and maintenance of anesthesia in neonates and children.However,a large number of clinical and basic studies have pointed out that sevoflurane may cause damage to the brain development of young children.Through consulting the relevant basic and clinical research data,this review summarized clinical and basic research evidences of sevoflurane-induced brain damage in children,as well as possible mechanisms including abnormal phosphorylation of Tau protein,inhibition of extracellular signal-regulated kinase phosphorylation by oxidative stress,Wnt/β-catenin signaling pathway,PERK-eIF2a-ATF4-CHOP signaling pathway and the regulation of p53-microRNA to miRNA-34c.We also further discussed the possible mechanism of anesthetic damage to the developing brain so as to provide reference for taking measures for brain protection in clinical practise.