非阿片类药物改善阿片类药物致呼吸抑制研究进展  

Research progress in improvement of opioid-induced respiratory depression by non-opioid drugs

作　　者：樊永正 雍政 苏瑞斌 FAN Yong-zheng;YONG Zheng;SU Rui-bin(Beijing Key laboratory of Neuropsychopharmacology,State Key Laboratory of Toxicology and Medical Countermeasures,Institute of Pharmacology and Toxicology,Academy of Military Medical Sciences,Beijing 100850,China;the 991th Hospital of Joint Logistic Support Force,Xiangyang 441000,China)

机构地区：[1]军事科学院军事医学研究院毒物药物研究所,抗毒药物与毒理学国家重点实验室,神经精神药理学北京市重点实验室,北京100850 [2]联勤保障部队第991医院,湖北襄阳441000

出　　处：《中国药理学与毒理学杂志》2021年第2期132-138,共7页Chinese Journal of Pharmacology and Toxicology

摘　　要：阿片类药物通过作用于阿片受体,激活与受体偶联的G蛋白和(或)β-抑制蛋白等信号通路而发挥镇痛和麻醉等效应,但同时阿片类药物致呼吸抑制(OIRD)则是临床常见的严重问题。目前通常采用阿片受体拮抗剂纳洛酮等改善OIRD,但纳洛酮可能会拮抗阿片类药物的镇痛作用,甚至带来许多不可预知的不良反应。近年来,使用非阿片类药物直接和(或)间接调节呼吸中枢,在改善OIRD的同时不影响阿片类药物的镇痛已成为一种新的研究思路。本文围绕近年来研究报道较多的α-氨基-3-羟基-5-甲基-4-恶唑丙酸受体调节剂、5-羟色胺受体激动剂、磷酸二酯酶4抑制剂、胶质细胞抑制剂、烟碱乙酰胆碱受体激动剂和钾离子通道阻滞剂等非阿片类药物展开综述。Opioid drugs activate G protein and(or)β-arrestin protein signaling pathways by acting on opioid receptors,which can generate analgesia and anesthesia effects,but at the same time,opioidinduced respiratory depression(OIRD)is a common severe clinical problem.Currently,naloxone,an opioid receptor antagonist,is usually used to improve respiratory depression,but naloxone may counteract the analgesic effect and even induce many unpredictable adverse reactions.In recent years,non-opioid drugs have been used to directly or indirectly regulate the respiratory center to improve OIRD without affecting analgesia,which is becoming a new area of research.This paper reviewed such non-opioid drugs as theα-amino-3-hydroxyl-5-methyl-4-isoxazole-propionic acid receptor modulator,5-hydroxytryptamine receptor agonist,phosphodiesterase-4 inhibitor,glial cell inhibitor,nicotinic acetylcholine receptor agonist,potassium ion channel blocker and other non-opioid drugs that have been much reported in recent years.

关 键 词：阿片受体 呼吸抑制 阿片类药物 

分 类 号：R964[医药卫生—药理学]