去甲肾上腺素在感染性休克期间对脑功能的影响

Effect of norepinephrine on brain function during septic shock

去甲肾上腺素(norepinephrine,NE)是一种主要由交感节后神经元和脑内肾上腺素能神经末梢合成和分泌的神经递质,血液中的NE主要来自肾上腺髓质.人工合成NE是一种升压药物,可有效用于多种危重患者的循环功能支持,目前NE常作为感染性休克患者血压维持的一线治疗药物.感染性休克期间应用NE维持患者循环功能,脑功能的改变却较少引起关注,NE有望减少脑功能障碍的发生,保护及改善脑功能,但具体作用机制较复杂.本文主要对NE与脑功能之间的相关调节机制进行综述,旨在为NE的临床合理应用提供参考.

Norepinephrine(NE)is a neurotransmitter mainly synthesized and secreted by post-sympathetic neurons and adrenergic nerve endings in the brain.In the blood,NE mainly comes from the adrenal medulla.Synthetie NE is a booster drug that can be effectively used to support circulatory function in a variety of critically ill patients.Currently,NE is often used as a first-line treatment for blood pressure maintenance in the patients with septic shock.During the application of NE to maintain circulatory function in the patients,changes in brain function have not attracted attention.NE is expected to reduce the occurrence of brain dysfunction,protect and improve brain function,but the specific mechanism of action is complicated.This review mainly introduces the possible regulatory mechanisms between NE and brain function,and aims to provide a reference for the rational clinical application of NE.