摘要
心脏骤停是人类死亡的主要原因之一,其中神经系统损伤是主要致死致残原因.目标温度管理(target temperature management,TTM)或治疗性低体温(therapeutic hypothermia,TH)是一种以物理方法将患者的体温降到预期水平而达到治疗疾病目的的方法,可以减少心跳骤停后的缺血性损伤,并能改善神经功能,提高生存率.在治疗过程中,通常需要给予镇静、镇痛和血管活性等药物.但由于药代动力学的变化,上述药物的生理学作用可能会因温度降低而改变,因此需考虑不同目标温度对药物代谢的影响.本综述讨论了目标温度管理通过降低脑代谢和保护血脑屏障等多方面来保护脑和全身的作用机制,总结了几项不同目标温度管理与各类药物的药代动力学改变以及对预后的影响,为动物或临床研究提供理论基础,以达到最佳脑保护治疗作用.
Cardiac arrest is one of the main causes of human death,among which nervous system injury is the main cause of death and disability.Target temperature management(TTM)or therapeutie hypothermia(TH)is a physical mcthod to reducc the patient's body temperature to the expected level to achieve the purpose of treatment of the disease,it can reduce ischemic damage after cardiac arrest and can improve neurological function and improve survival.In the course of this treatment,sedation,analgesia and vasoactive drugs are usually given.But due to the change of pharmacokinetics.the physiological effects of these drugs may change with the decrease of temperature.Therefore,the ffects of different target temperatures on drug metabolism should be considered.In this review,the mechanism of target temperature management in protecting brain and whole body by reducing brain metabolism and protecting blood-brain barrier is discussed and several different target temperature management and pharmacokinetic changes of various drugs as well as the impact on prognosis are summarized to provide a theoretical basis for animal or clinical research to achieve the best brain protection treatment.
作者
热依拉·拜克力
穆叶赛·尼加提
REYILA·Baikeli;MUYESAI·Nijiati(Department of Cardiology,Xinjiang Uygur Autonomous Regional People's Hospital,Urumchi 830001,China;Emergency Center of Region,Xinjiang Uygur Autonomous Regional People's Hospital,Urumchi 830001,China)
出处
《中国心血管病研究》
CAS
2020年第9期850-854,859,共6页
Chinese Journal of Cardiovascular Research
基金
国家自然科学基金项目(81760068)。
关键词
目标温度管理
治疗性低体温
药物代谢
Target temperature management
Therapeutic hy pothermia
Drug metabolism
