右美托咪定抗缺血再灌注损伤作用机制的研究现状

Mechanism of dexmedetomidine against ischemia reperfusion injury

缺血再灌注损伤围手术期发生率和死亡率极高。右美托咪定是一种选择性α2肾上腺素能受体激动剂,广泛应用于临床麻醉和重症监护病房镇静。右美托咪定对缺血再灌注损伤有保护作用,它通过清除自由基、抗氧化、减轻氧化应激反应损伤,通过抑制TLR4/NF-κB通路减轻炎症反应,通过线粒体途径和PI3K/Akt信号通路抗细胞凋亡,通过Bcl-2/Beclin-1信号通路和上调HIF-1α等抗自噬,减轻缺血再灌注损伤。

The perioperative incidence and mortality of ischemia reperfusion(IR) injury are extremely high.Dexmedetomidine(Dex), a selective 2 adrenergic receptor agonist, is widely used in clinical anesthesia and intensive care unit sedation. It was shown that dexmedetomidine has a protective effect on IR injury, it can reduce oxidative stress injury by scavenging free radicals, inhibiting the TLR4/NF-κB pathway, alleviating inflammatory reaction, preventing apoptosis by mitochondrial and PI3K/Akt signaling pathways, preventing autophagy by the Bcl-2/Beclin-1 signaling pathway and upregulating HIF-1α to alleviate IR injury.