阿片受体在氯胺酮药理效应中的作用机制研究

Research on mechanism of opioid receptors in pharmacological effects of ketamine

氯胺酮自1970年起在临床上被用作镇痛剂和麻醉剂,近年因被发现具有快速有效的抗抑郁作用而备受关注。然而,氯胺酮引起的成瘾、致幻等精神类不良反应限制了其临床应用,但不良反应的具体机制尚不明确。目前,学界普遍认为氯胺酮的药理效应主要由N-甲基-D-天冬氨酸(N-methyl-D-aspartic acid,NMDA)受体介导,但越来越多的研究证据提示阿片受体在氯胺酮的药理效应中也有重要作用。该综述基于近20年公开发表的相关文献,总结了阿片受体在氯胺酮麻醉、镇痛、抗抑郁、抗成瘾和成瘾等药理效应中的机制,为揭示氯胺酮的作用机制提供参考,为解决氯胺酮的临床副作用做出有益探索。

Ketamine has been used clinically as an analgesic and anesthetic since 1970.Recently,it has been concerned due to its rapid and effective antidepressant effect.However,the psychiatric adverse reactions caused by ketamine such as addiction and hallucination limit its clinical application,yet the mechanism of the adverse reactions is still unclear.At present,it is generally believed that the pharmacological effects of ketamine are mainly mediated by N-methyl-D-aspartate acid(NMDA)receptors,but increasing numbers of research evidences suggest that the opioid receptor also play an important role in the pharmacological effects of ketamine.This review,based on the relevant literature published publicly in the past 20 years,summarizes the mechanisms of opioid receptors in the pharmacological effects of ketamine,such as anesthesia,analgesia,anti-depressant,anti-addiction and addiction,providing reference for revealing the mechanism of ketamine,and making beneficial exploration for solving the clinical side effects of ketamine.