摘要
全麻药物对发育期大脑的影响是近二十年来麻醉领域中关注热点之一。目前已有大量的基础研究显示,全麻药物可损伤发育期大脑,并导致长期认知功能异常;而临床研究结果则存在争议。由于基础研究向临床转化的局限性和回顾性临床研究本身的缺陷、临床试验中标准化行为学及智力评分工具的缺乏以及其他的混杂因素,这一争议短时间内无法得到解决,当前研究结论亦难以指导临床实践。结合当前研究现状、联系全麻机制研究进展及反思笔者近十年来在该领域探索,总结当前研究存在的问题及混杂因素供后续研究参考,以提高未来研究数据的可重复性和说服力,更好地指导小儿麻醉实践。
The effect of general anesthetics(GA)on the developing brain has been a research hotspot in the last two decades.Numerous studies have shown that GA could damage the developing brain and cause long-term cognitive impairment in the preclinical setting,while it remains controversial in the clinical context regarding this topic.In light of the limitations of directly translating the preclinical findings into clinical context,drawbacks of retrospective studies,lack of standard behavioral and mental assessing tools in clinical studies,and other confounding factors,it is difficult to gain an agreement on the issue.To improve the repeatability and persuasion of data in the field of GA-induced developing brain,we tried to integrally analyze the current status and progress of the topic and make it as reference for the related studies in the future.
作者
杨柳
罗爱林
李世勇
YANG Liu;LUO Ailin;LI Shiyong(Department of Anesthesiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China)
出处
《中国临床药理学与治疗学》
CAS
CSCD
2022年第12期1381-1390,共10页
Chinese Journal of Clinical Pharmacology and Therapeutics
基金
国家重点研发计划(2020YFC2009002)。
关键词
全麻药物
发育期神经系统
神经毒性
凋亡
general anesthetics
developing brain
neurotoxicity
apoptosis