吸入麻醉药预处理心肌保护作用的临床研究进展  

Advance in Clinical Study of Volatile Anesthetic Preconditioning-Induced Myocardial Protection

作　　者：孙颖[1] 罗光慧[1] 冯志佳[1] 薄玉龙[1] 

机构地区：[1]哈尔滨医科大学第二附属医院麻醉科,黑龙江哈尔滨150086

出　　处：《现代生物医学进展》2012年第22期4384-4386,共3页Progress in Modern Biomedicine

摘　　要：心肌梗死是围术期最严重的并发症之一,所以减少围术期心肌梗死的风险对于围术期麻醉十分重要。大量实验研究证明,吸入麻醉药预处理可以有效减轻心肌的缺血/再灌注损伤,减少心肌梗死范围,促进心脏功能的恢复。麻醉药预处理是一个复杂的过程,这一过程触发了两个不同的时相。第一,简称为早期预处理(E预处理),包括心肌细胞内有保护作用的酶的激活;第二,称为晚期预处理(L预处理),依赖于新的心肌保护蛋白的从头合成。虽然早期预处理和晚期预处理对心肌细胞的影响是挥发性麻醉药心脏保护作用的关键,但他们对冠状动脉内皮细胞的影响也很重要,这一机制可能改善了冠状动脉手术患者的长期预后。挥发性麻醉药,对改善围术期有心肌梗死风险的非心脏手术患者的预后,尚没有得到有明确意义的证实。Myocardial infarction represents one of the most serious perioperative complications.Reducing the risk of perioperative myocardial infarction is one of the most important priorities of anesthetic treatment.Many experimental evidence has have demonstrated that volatile anesthetics preconditioning can effectively reduce myocardial ischemia-reperfusion injury,decrease myocardial infarct size and promote cardiac function to recovery.Anesthetic preconditioning is a complex process which is divided into two separate phenomena initiated by the same event.The first,referred to as early preconditioning,involves activation of protective enzymes within cardiomyocytes and the second,referred to as late preconditioning,is dependent on the novo synthesis of these protective proteins.Although pre-,as well as post-conditioning＇s effects on cardiomyocytes are crucial for cardioprotective effects of volatile anesthetics,their influence on coronary endothelium may be even more important for the improvement of the long-term prognosis,demonstrated in coronary surgery patients.Improved outcome after anesthesia with volatile anesthetics in non-cardiac surgical patients at risk of perioperative myocardial infarction has not been univocally demonstrated yet.

关 键 词：吸入麻醉药 预处理 心肌保护 

分 类 号：R614[医药卫生—麻醉学] R54[医药卫生—外科学]