The progress of clinical uses of α2-adrenergic agonists in the peri-operative period

α2-adrenergic agonists produce sedation, anxiolysis, sympatholysis, and possess some analgesic properties because of the effect that decreasing the release of the norepinephrine in the sympathetic nerves ending of peripheral and central nervous system. The uses of α2 -adrenergic agonists such as cloniding and dexmedetomidine in the peri-operative period produced sedation, analgesia, and maintained the hemodynamic state stable. At the same time, it decreased the opioids consumption and its side effects. The clinical uses of clonidine and dexmedetomidine still needs further study.     

α2-受体激动剂在围术期中的应用进展

α2-受体激动剂作用于外周和中枢神经系统的交感神经末梢,减少去甲肾上腺素的释放,可产生镇静、抗焦虑、抗交感必奋作用以及一定的镇痛作用.临床应用的α2-受体激动剂,主要是可乐定或右旋美托咪啶(dexmedemtomidine,DEX),可在术前、术中或术后应用,产生镇静、镇痛等作用,同时维持血流动力学稳定,减少阿片类药物的用量及其副作用.关于可乐定和右旋美托咪啶的临床应用仍需要关注.     

右旋美托咪啶在创伤性脑损伤中应用的研究进展

背景 右旋美托咪啶( dexmedetomidine,DEX)是新型的高选择性α2肾上腺素受体激动剂,具有镇静、镇痛和抗交感等作用,其特点为镇静易于唤醒,且对呼吸无抑制作用.脑损伤患者需要适当镇静降低脑氧耗,减少继发性脑损伤,同时又要求易于唤醒便于临床医生判断神智.目的 综述DEX在创伤性脑损伤(traumatic brain injury,TBI)中应用的研究进展,为该药在临床工作中的应用提供参考.内容 从作用机制、对脑损伤的影响及临床应用3个方面论述DEX对TBI的影响.趋向 DEX具有镇静、抗交感、抗凋亡等多种神经保护作用,且其无呼吸抑制,不影响对患者神智判断,这些特性似乎使其成为较有前景的脑创伤镇静剂.但目前DEX在脑创伤动物模型或患者中研究甚少,我们仍然不清楚其在脑创伤动物模型或患者的综合作用如何.     

Effects of α1-adrenergic receptor on the proliferation of cholangiocarcinoma cells

Objective To investigate the correlation between α1-adrenergic receptor and the pathological behavior of cholangiocarcinoma, and the effects of norepinephrine (NE) on the proliferation of cholangiocarcinoma cell line QBC939. Methods Thirty-six samples of cholangiocarcinoma were resected in Southwest Hospital from August 2002 to March 2008. The expression of α1-adrenergic receptor in the 36 samples of cholangiocarcinoma tissue and 4 samples of normal bile duct tissue were detected by SABC technique. The proliferation of cholangio-carcinoma cell line QBC939 was detected after processing the cells with NE, phentolamine and prazosin. All the data were analyzed by chi-square test. Results The high positive expression rate of α1-adrenergic receptor was 68% (17/25) in patients with lymph node metastasis, which was significantly higher than 9% (1/11) in patients without lymph node metastasis (χ2=10.604, P<0.05). The high positive expression rate of α1-adrenergic receptor was 85% (11/13) in patients with middle and low positioned cholangiocarcinoma, which was significantly higher than 30% (7/23) in patients with hilar cholangiocarcinoma (χ2=9.753, P<0.05). NE promoted the proliferation of cholangiocarcinoma cell line QBC939 by stimulating the expression of α1-adrenergic receptor, and in a concentration-dependent manner. The proliferative effect was weakened as time passed by, and it was eliminated by phentolamine and prazosin. Conclusions The expression of α1-adrenergic receptor is diverse due to lymph node metastasis and the location of the tumor, α1-adrenergic receptor with high expression may play an important role in the proliferation and metastasis of cholangiocarcinoma.     

Effects of α1-adrenergic receptor on the proliferation of cholangiocarcinoma cells

Objective To investigate the correlation between α1-adrenergic receptor and the pathological behavior of cholangiocarcinoma, and the effects of norepinephrine (NE) on the proliferation of cholangiocarcinoma cell line QBC939. Methods Thirty-six samples of cholangiocarcinoma were resected in Southwest Hospital from August 2002 to March 2008. The expression of α1-adrenergic receptor in the 36 samples of cholangiocarcinoma tissue and 4 samples of normal bile duct tissue were detected by SABC technique. The proliferation of cholangio-carcinoma cell line QBC939 was detected after processing the cells with NE, phentolamine and prazosin. All the data were analyzed by chi-square test. Results The high positive expression rate of α1-adrenergic receptor was 68% (17/25) in patients with lymph node metastasis, which was significantly higher than 9% (1/11) in patients without lymph node metastasis (χ2=10.604, P<0.05). The high positive expression rate of α1-adrenergic receptor was 85% (11/13) in patients with middle and low positioned cholangiocarcinoma, which was significantly higher than 30% (7/23) in patients with hilar cholangiocarcinoma (χ2=9.753, P<0.05). NE promoted the proliferation of cholangiocarcinoma cell line QBC939 by stimulating the expression of α1-adrenergic receptor, and in a concentration-dependent manner. The proliferative effect was weakened as time passed by, and it was eliminated by phentolamine and prazosin. Conclusions The expression of α1-adrenergic receptor is diverse due to lymph node metastasis and the location of the tumor, α1-adrenergic receptor with high expression may play an important role in the proliferation and metastasis of cholangiocarcinoma.     

Effects of α1-adrenergic receptor on the proliferation of cholangiocarcinoma cells

Objective To investigate the correlation between α1-adrenergic receptor and the pathological behavior of cholangiocarcinoma, and the effects of norepinephrine (NE) on the proliferation of cholangiocarcinoma cell line QBC939. Methods Thirty-six samples of cholangiocarcinoma were resected in Southwest Hospital from August 2002 to March 2008. The expression of α1-adrenergic receptor in the 36 samples of cholangiocarcinoma tissue and 4 samples of normal bile duct tissue were detected by SABC technique. The proliferation of cholangio-carcinoma cell line QBC939 was detected after processing the cells with NE, phentolamine and prazosin. All the data were analyzed by chi-square test. Results The high positive expression rate of α1-adrenergic receptor was 68% (17/25) in patients with lymph node metastasis, which was significantly higher than 9% (1/11) in patients without lymph node metastasis (χ2=10.604, P<0.05). The high positive expression rate of α1-adrenergic receptor was 85% (11/13) in patients with middle and low positioned cholangiocarcinoma, which was significantly higher than 30% (7/23) in patients with hilar cholangiocarcinoma (χ2=9.753, P<0.05). NE promoted the proliferation of cholangiocarcinoma cell line QBC939 by stimulating the expression of α1-adrenergic receptor, and in a concentration-dependent manner. The proliferative effect was weakened as time passed by, and it was eliminated by phentolamine and prazosin. Conclusions The expression of α1-adrenergic receptor is diverse due to lymph node metastasis and the location of the tumor, α1-adrenergic receptor with high expression may play an important role in the proliferation and metastasis of cholangiocarcinoma.     

Effects of α1-adrenergic receptor on the proliferation of cholangiocarcinoma cells

Objective To investigate the correlation between α1-adrenergic receptor and the pathological behavior of cholangiocarcinoma, and the effects of norepinephrine (NE) on the proliferation of cholangiocarcinoma cell line QBC939. Methods Thirty-six samples of cholangiocarcinoma were resected in Southwest Hospital from August 2002 to March 2008. The expression of α1-adrenergic receptor in the 36 samples of cholangiocarcinoma tissue and 4 samples of normal bile duct tissue were detected by SABC technique. The proliferation of cholangio-carcinoma cell line QBC939 was detected after processing the cells with NE, phentolamine and prazosin. All the data were analyzed by chi-square test. Results The high positive expression rate of α1-adrenergic receptor was 68% (17/25) in patients with lymph node metastasis, which was significantly higher than 9% (1/11) in patients without lymph node metastasis (χ2=10.604, P<0.05). The high positive expression rate of α1-adrenergic receptor was 85% (11/13) in patients with middle and low positioned cholangiocarcinoma, which was significantly higher than 30% (7/23) in patients with hilar cholangiocarcinoma (χ2=9.753, P<0.05). NE promoted the proliferation of cholangiocarcinoma cell line QBC939 by stimulating the expression of α1-adrenergic receptor, and in a concentration-dependent manner. The proliferative effect was weakened as time passed by, and it was eliminated by phentolamine and prazosin. Conclusions The expression of α1-adrenergic receptor is diverse due to lymph node metastasis and the location of the tumor, α1-adrenergic receptor with high expression may play an important role in the proliferation and metastasis of cholangiocarcinoma.     

Effects of α1-adrenergic receptor on the proliferation of cholangiocarcinoma cells

Objective To investigate the correlation between α1-adrenergic receptor and the pathological behavior of cholangiocarcinoma, and the effects of norepinephrine (NE) on the proliferation of cholangiocarcinoma cell line QBC939. Methods Thirty-six samples of cholangiocarcinoma were resected in Southwest Hospital from August 2002 to March 2008. The expression of α1-adrenergic receptor in the 36 samples of cholangiocarcinoma tissue and 4 samples of normal bile duct tissue were detected by SABC technique. The proliferation of cholangio-carcinoma cell line QBC939 was detected after processing the cells with NE, phentolamine and prazosin. All the data were analyzed by chi-square test. Results The high positive expression rate of α1-adrenergic receptor was 68% (17/25) in patients with lymph node metastasis, which was significantly higher than 9% (1/11) in patients without lymph node metastasis (χ2=10.604, P<0.05). The high positive expression rate of α1-adrenergic receptor was 85% (11/13) in patients with middle and low positioned cholangiocarcinoma, which was significantly higher than 30% (7/23) in patients with hilar cholangiocarcinoma (χ2=9.753, P<0.05). NE promoted the proliferation of cholangiocarcinoma cell line QBC939 by stimulating the expression of α1-adrenergic receptor, and in a concentration-dependent manner. The proliferative effect was weakened as time passed by, and it was eliminated by phentolamine and prazosin. Conclusions The expression of α1-adrenergic receptor is diverse due to lymph node metastasis and the location of the tumor, α1-adrenergic receptor with high expression may play an important role in the proliferation and metastasis of cholangiocarcinoma.     

Effects of α1-adrenergic receptor on the proliferation of cholangiocarcinoma cells

Objective To investigate the correlation between α1-adrenergic receptor and the pathological behavior of cholangiocarcinoma, and the effects of norepinephrine (NE) on the proliferation of cholangiocarcinoma cell line QBC939. Methods Thirty-six samples of cholangiocarcinoma were resected in Southwest Hospital from August 2002 to March 2008. The expression of α1-adrenergic receptor in the 36 samples of cholangiocarcinoma tissue and 4 samples of normal bile duct tissue were detected by SABC technique. The proliferation of cholangio-carcinoma cell line QBC939 was detected after processing the cells with NE, phentolamine and prazosin. All the data were analyzed by chi-square test. Results The high positive expression rate of α1-adrenergic receptor was 68% (17/25) in patients with lymph node metastasis, which was significantly higher than 9% (1/11) in patients without lymph node metastasis (χ2=10.604, P<0.05). The high positive expression rate of α1-adrenergic receptor was 85% (11/13) in patients with middle and low positioned cholangiocarcinoma, which was significantly higher than 30% (7/23) in patients with hilar cholangiocarcinoma (χ2=9.753, P<0.05). NE promoted the proliferation of cholangiocarcinoma cell line QBC939 by stimulating the expression of α1-adrenergic receptor, and in a concentration-dependent manner. The proliferative effect was weakened as time passed by, and it was eliminated by phentolamine and prazosin. Conclusions The expression of α1-adrenergic receptor is diverse due to lymph node metastasis and the location of the tumor, α1-adrenergic receptor with high expression may play an important role in the proliferation and metastasis of cholangiocarcinoma.     

Effects of α1-adrenergic receptor on the proliferation of cholangiocarcinoma cells

Objective To investigate the correlation between α1-adrenergic receptor and the pathological behavior of cholangiocarcinoma, and the effects of norepinephrine (NE) on the proliferation of cholangiocarcinoma cell line QBC939. Methods Thirty-six samples of cholangiocarcinoma were resected in Southwest Hospital from August 2002 to March 2008. The expression of α1-adrenergic receptor in the 36 samples of cholangiocarcinoma tissue and 4 samples of normal bile duct tissue were detected by SABC technique. The proliferation of cholangio-carcinoma cell line QBC939 was detected after processing the cells with NE, phentolamine and prazosin. All the data were analyzed by chi-square test. Results The high positive expression rate of α1-adrenergic receptor was 68% (17/25) in patients with lymph node metastasis, which was significantly higher than 9% (1/11) in patients without lymph node metastasis (χ2=10.604, P<0.05). The high positive expression rate of α1-adrenergic receptor was 85% (11/13) in patients with middle and low positioned cholangiocarcinoma, which was significantly higher than 30% (7/23) in patients with hilar cholangiocarcinoma (χ2=9.753, P<0.05). NE promoted the proliferation of cholangiocarcinoma cell line QBC939 by stimulating the expression of α1-adrenergic receptor, and in a concentration-dependent manner. The proliferative effect was weakened as time passed by, and it was eliminated by phentolamine and prazosin. Conclusions The expression of α1-adrenergic receptor is diverse due to lymph node metastasis and the location of the tumor, α1-adrenergic receptor with high expression may play an important role in the proliferation and metastasis of cholangiocarcinoma.     

Effects of α1-adrenergic receptor on the proliferation of cholangiocarcinoma cells

Objective To investigate the correlation between α1-adrenergic receptor and the pathological behavior of cholangiocarcinoma, and the effects of norepinephrine (NE) on the proliferation of cholangiocarcinoma cell line QBC939. Methods Thirty-six samples of cholangiocarcinoma were resected in Southwest Hospital from August 2002 to March 2008. The expression of α1-adrenergic receptor in the 36 samples of cholangiocarcinoma tissue and 4 samples of normal bile duct tissue were detected by SABC technique. The proliferation of cholangio-carcinoma cell line QBC939 was detected after processing the cells with NE, phentolamine and prazosin. All the data were analyzed by chi-square test. Results The high positive expression rate of α1-adrenergic receptor was 68% (17/25) in patients with lymph node metastasis, which was significantly higher than 9% (1/11) in patients without lymph node metastasis (χ2=10.604, P<0.05). The high positive expression rate of α1-adrenergic receptor was 85% (11/13) in patients with middle and low positioned cholangiocarcinoma, which was significantly higher than 30% (7/23) in patients with hilar cholangiocarcinoma (χ2=9.753, P<0.05). NE promoted the proliferation of cholangiocarcinoma cell line QBC939 by stimulating the expression of α1-adrenergic receptor, and in a concentration-dependent manner. The proliferative effect was weakened as time passed by, and it was eliminated by phentolamine and prazosin. Conclusions The expression of α1-adrenergic receptor is diverse due to lymph node metastasis and the location of the tumor, α1-adrenergic receptor with high expression may play an important role in the proliferation and metastasis of cholangiocarcinoma.     

右旋美托咪啶的药理和临床应用

本文介绍α_2肾上腺素能受体激动药右旋美托咪啶(DMED)的药理作用和临床试用近况。DMED为高效、高选择性的α_2受体激动药,具有抑制交感神经、镇静、催眠、镇痛和麻醉作用,不良反应少且轻。临床试用结果表明,此药可使麻醉药用量明显减少,抑制气管插管时的应激反应,降低限内压,减少麻醉恢复期激动和恶心,并可用于术后镇痛,是很有前途的麻醉辅助药。     

右美托咪啶的临床麻醉应用进展

背景 右美托咪啶为高效、高选择性的α2肾上腺素受体激动剂,具有镇静、镇痛和抗焦虑等作用.自1999年美国FDA批准将其用于ICU的镇静以来,其在临床麻醉中的应用也日益广泛.目的 综述右美托咪啶在临床麻醉中的应用进展,为该药在临床工作中的应用提供参考.内容 此文分别从作用机制及临床应用两方面,综述了右美托咪啶的镇静作用,...     

右美托咪啶的临床麻醉应用进展

背景 右美托咪啶为高效、高选择性的α2肾上腺素受体激动剂,具有镇静、镇痛和抗焦虑等作用.自1999年美国FDA批准将其用于ICU的镇静以来,其在临床麻醉中的应用也日益广泛.目的 综述右美托咪啶在临床麻醉中的应用进展,为该药在临床工作中的应用提供参考.内容 此文分别从作用机制及临床应用两方面,综述了右美托咪啶的镇静作用,镇痛作用,抑制术中应激反应,麻醉辅助作用及对术后恢复的影响等内容.趋向 右美托咪啶作为新型的麻醉辅助用药,其在临床麻醉中的应用具有广泛前景.     

右美托咪啶在小儿心脏手术中的应用进展

背景 右美托咪啶(dexmedetomidine,DEX)是一种新型高选择性α2肾上腺素能受体激动剂,有镇静、镇痛、抗焦虑作用且对呼吸抑制轻微;同时可维持血流动力学稳定,减少阿片类药物的用量及其副作用,可广泛用于成年人,能否安全用于小儿值得关注.目的 阐述DEX在小儿心脏手术中应用的安全性和有效性.内容 概述DEX对小儿心脏手术血流动力学、呼吸和苏醒时间以及心电图的影响,并探讨其在儿科重症监护病房(ICU)中的应用.趋向 DEX在小儿麻醉中的用药经验较为欠缺,其确切的作用机制及安全剂量范围仍需探索,以便为临床应用提供更好的基础.     

右美托咪定对于提高术后恢复质量的研究进展

背景右美托咪定（dexmedetomidine,Dex）是一种高度选择性的仅α2肾上腺受体激动剂,具有镇静、镇痛、抗炎、抗焦虑作用,在围手术期得到广泛应用。目的为Dex提高术后恢复质量的进一步临床研究提供参考。内容介绍麻醉和手术后恢复质量测量的相关量表、临床研究,探讨Dex提高恢复质量的相关机制。趋向Dex可有效提高患者术后的恢复质量。     

右美托咪啶在心脏手术围术期的应用

背景 右美托咪啶(dexmedetomidine,DEX)作为一种高效的α2受体激动剂,不仅具有镇静、镇痛、抗焦虑作用,还有使心脏高危情形受益的抗交感,心肌自律性阻滞作用,因此被越来越多的用于心脏手术围术期.目的 概述及评价DEX在心脏手术围术期应用的有效性及安全性,为临床用药提供参考.内容 阐述DEX心血管系统药理学...     

α_2肾上腺素受体激动药及其临床应用进展

α_2肾上腺素受体(α_2—AR)激动药,主要通过脊髓α_2A/O—AR产生镇痛、镇静效应。临床应用中,具有减少麻醉药用量、术后镇痛与其他镇痛药相互协同的特点。本文综述了α_2—AR的分型、作用机制、中枢分布及药理作用,并介绍了α_2—AR激动药在术前、术中、术后的临床应用特点。     

α_2受体激动药

介绍α_2受体激动药可乐定和右美托咪啶的药理性质,对生理功能的影响以及临床应用。α_2受体激动药使吸入麻醉药MAC降低,对手术刺激有抑制作用,使循环系统隐定,并行增强和延长镇痛效果,对术后镇痛有良好作用。     

右美托咪啶对老年患者术后认知功能和围术期单核细胞Toll样受体2和Toll样受体4表达的影响

目的 探讨右美托咪啶对老年患者术后认知功能和围术期单核细胞Toll样受体2(TLR2)和TLR4表达的影响.方法 择期手术治疗的腰椎间盘突出症和腰椎骨折患者45例,年龄≥65岁,体重53～72 kg,ASA分级Ⅰ或Ⅱ级,采用随机数字表法,将其随机分为3组(n=15):对照组(Ⅰ组)和不同剂量右美托咪啶组(Ⅱ组和Ⅲ组).麻醉诱导结束后静脉输注右美托咪啶负荷剂量1.0μg/kg,输注时间15 min,然后以0.5μg/·kg-1·h-1(Ⅱ组)或1.0 μg·Jg-1·h-1(Ⅲ组)的速率静脉输注至术毕,Ⅰ组给予等容量生理盐水.于麻醉诱导前(T1)、手术开始1.5 h(T2)、术毕(T3)和术后24 h(T4)时取静脉血样,检测外周血单核细胞TLR2及TLR4的表达.分别于术前1d和术后7d时采用简易精神状态量表评分和韦氏成人记忆量表及智力量表评价认知功能,记录术后认知功能障碍的发生情况.结果 与Ⅰ组比较,Ⅱ组和Ⅲ组术后认知功能障碍发生率降低,T2～T4时单核细胞TLR2和TLR4表达下调(P＜0.05);与Ⅱ组比较,Ⅲ组术后认知功能障碍发生率降低,T～T4时单核细胞TLR2和TLR4表达下调(P＜0.05).结论 右美托咪啶可预防老年患者POCD的发生,其机制与抑制单核细胞TLR2和TLR4的表达有关.