摘要
背景瑞芬太尼是一超短效阿片受体激动剂，可有效抑制心血管应激反应，维持血液动力学稳定；研究发现瑞芬太尼预处理及后处理可减轻心肌缺血，再灌注损伤（ischemia／reperfusion injury，I／RI）。目的就瑞芬太尼心肌保护作用的研究进展作一综述，使人们系统地了解瑞芬太尼的心肌保护作用及其可能机制。内容主要从瑞芬太尼的药代动力学与药效学；瑞芬太尼可有效抑制过强的应激反应引起心肌损伤；瑞芬太尼预处理（remifentanil precorditioning，RPC）及后处理的心肌保护作用及其可能机制等方面进行展开阐述。趋向近年来，动物实验和临床试验均表明RPC及后处理具有确定的心肌保护作用，但其临床运用仍比较局限，所以RPC及后处理对临床心肌I／RI的保护作用及其机制需进一步研究。
Background Remifentanil is an ultra-short-acting agonist to opioid receptor, which inhibits the cardiovascular stress response and maintains the hemodynamie stability. Studies on it had found that preconditioning and posteonditioning with remifentanil could reduce myocardial ischemia reperfusion injury. Objective This review focused on the researches in myocardial protective effect of, remifentanil, offeringa systematic understanding of the cardioprotective effect of remifentanil and its possible mechanisms. Content This review included the following parts： Pharmaeokinetics and phamlaeodynamics of remifentanil; Inhibiting the excessive stress response which resulted in myocardial injury; The cardioprotective effect of remifentanil preconditioning and postconditioning and its possible mechanisms. Trend In recent years, several studies have reported that remifentanil preconditioning and postconditioning confer myocardial protection effect, but the clinical use of it is still relatively limited. Therefore, the myocardial protective effects of remifentanil preconditioning and postconditioning in patients and its possible mechanisms need further study.
出处
《国际麻醉学与复苏杂志》
CAS
2011年第4期446-450,共5页
International Journal of Anesthesiology and Resuscitation
关键词
瑞芬太尼
心肌保护
应激反应
缺血预处理
缺血后处理
Remifentanil
Myocardial protection
Stress response
Ischemic preconditioning
Ischemic postconditioning
