氯胺酮抗抑郁作用的神经生物学机制研究进展  

Research progress on neurobiological mechanisms underlying antidepressant effect of ketamine

作　　者：周冬雨 章文欣 翟晓静 陈丹丹 韩奕 季然 潘晓媛 曹君利[1,2] 张红星 ZHOU Dong-yu;ZHANG Wen-xin;ZHAI Xiao-jing;CHEN Dan-dan;HAN Yi;JI Ran;PAN Xiao-yuan;CAO Jun-li;ZHANG Hong-xing(Jiangsu Province Key Laboratory of Anesthesiology,Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology,NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs,Xuzhou Jiangsu 221004,China;Dept of Anesthesiology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou Jiangsu 221002,China)

机构地区：[1]江苏省麻醉学重点实验室,江苏省麻醉与镇痛应用技术重点实验室,国家药品监督管理局麻醉精神药物研究与评价重点实验室,江苏徐州221004 [2]徐州医科大学附属医院麻醉科,江苏徐州221002

出　　处：《中国药理学通报》2024年第9期1622-1627,共6页Chinese Pharmacological Bulletin

基　　金：国家自然科学基金资助项目(No 31970937,82271255);江苏省研究生科研创新计划资助项目(No KYCX21_2713)。

摘　　要：重性抑郁障碍又称临床抑郁症,具有发病率高、致残率高、治愈率低等特点。传统的抗抑郁药物起效缓慢、治愈率低,对难治性抑郁症治疗效果不佳。有研究提示,非选择性N-甲基-D-天门冬氨酸受体拮抗剂氯胺酮,单次亚麻醉剂量治疗即可产生快速起效和持续的抗抑郁作用,并且对难治性抑郁症患者有效,明显缓解了难治性抑郁症患者的自杀倾向,但其作用机制尚不完全清楚。既往研究显示,氯胺酮的抗抑郁作用机制可能涉及单胺能系统、谷氨酸能系统、多巴胺能系统,该文将从以上几个系统分别总结氯胺酮抗抑郁的药理学机制,并对未来的研究方向进行展望。Major depressive disorder(MDD)is a prevalent condition associated with substantial impairment and low remission rates.Traditional antidepressants demonstrate delayed effects,low cure rate,and inadequate therapeutic effectiveness for managing treatment-resistant depression(TRD).Several studies have shown that ketamine,a non-selective N-methyl-D-aspartate receptor(NMDAR)antagonist,can produce rapid and sustained antidepressant effects.Ketamine has demonstrated efficacy for reducing suicidality in TRD patients.However,the pharmacological mechanism for ketamine's antidepressant effects remains incompletely understood.Previous research suggests that the antidepressant effects of ketamine may involve the monoaminergic,glutamatergic and dopaminergic systems.This paper provides an overview of the pharmacological mechanism for ketamine's antidepressant effects and discuss the potential directions for future research.

关 键 词：氯胺酮 抑郁症 抗抑郁 单胺能系统 谷氨酸能系统 多巴胺能系统 

分 类 号：R322.81[医药卫生—人体解剖和组织胚胎学] R749.42[医药卫生—基础医学] R971.2