Research progress on organ protective effects and mechanisms of dexmedetomidine

Ding Yun-Ying; Ji Fu-Hai; Peng Ke

doi:10.11855/j.issn.0577-7402.2532.2023.0530

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Research progress on organ protective effects and mechanisms of dexmedetomidine

Special issue | 更新时间：2023-12-13

- Research progress on organ protective effects and mechanisms of dexmedetomidine
- Medical Journal of Chinese People′s Liberation Army Vol. 48, Issue 11, Pages: 1267-1275(2023)
- 作者机构：
  
  1.苏州大学附属第一医院麻醉科，江苏苏州 215006
- 作者简介：
  
  E-mail: pengke0422@163.com
- 基金信息：
  
  the National Natural Science Foundation of China(82072130;81873925);the Jiangsu Provincial Medical Youth Talents Program(QNRC2016741)
- DOI：10.11855/j.issn.0577-7402.2532.2023.0530
  CLC：
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丁允莹, 嵇富海, 彭科. 右美托咪定的器官保护作用及其机制概述[J]. 解放军医学杂志, 2023, 48(11): 1267-1275.

Ding Yun-Ying,Ji Fu-Hai,Peng Ke.Research progress on organ protective effects and mechanisms of dexmedetomidine[J].Medical Journal of Chinese People′s Liberation Army,2023,48(11):1267-1275.
丁允莹, 嵇富海, 彭科. 右美托咪定的器官保护作用及其机制概述[J]. 解放军医学杂志, 2023, 48(11): 1267-1275. DOI： 10.11855/j.issn.0577-7402.2532.2023.0530.

Ding Yun-Ying,Ji Fu-Hai,Peng Ke.Research progress on organ protective effects and mechanisms of dexmedetomidine[J].Medical Journal of Chinese People′s Liberation Army,2023,48(11):1267-1275. DOI： 10.11855/j.issn.0577-7402.2532.2023.0530.

摘要

右美托咪定作为一种高选择性α,2,肾上腺素能受体激动剂，具有抗交感、镇静、镇痛、抗焦虑作用，且对呼吸影响轻微，近年来已在临床麻醉、围手术期治疗、重症监护领域得到广泛应用。器官功能保护是麻醉和围手术期医学的重要关注点，对于减少并发症、改善短期和长期预后具有重要临床意义。越来越多的基础研究和临床证据显示，右美托咪定对心、脑、肺、肾、肝及胃肠道等重要脏器具有保护作用，其机制可能与抗炎、抗氧化应激、抗凋亡、调节自噬等有关。本文对右美托咪定的器官保护作用及其机制进展进行阐述，以加深临床医师对个体化原则的应用，在发挥右美托咪定器官保护作用的同时避免增加低血压、心动过缓等不良反应，并进一步开展设计严谨的临床研究与深入的机制探索，以指导临床上以最优方式应用右美托咪定，更好地保护围手术期患者的器官功能。

Abstract

Dexmedetomidine is a highly selective α,2, adrenergic receptor agonist, exerting anti-sympathetic, sedative, analgesic and anti-anxiety effects, with minimal impact on respiration. In recent years, dexmedetomidine has been widely used in clinical anesthesia, perioperative treatment, and intensive care. Organ-protection is an important focus of anesthesia and perioperative medicine, with clinical significance in reducing complications and improving short- and long-term outcomes. Increasing clinical evidence and basic research have shown that the application of dexmedetomidine could protect the heart, brain, lung, kidney, liver, gastrointestinal tract and other important organs. The mechanism may be related to dexmedetomidine's effects of anti-inflammation, anti-oxidation, anti-apoptosis, and autophagy regulation. From our perspectives, clinical use should follow the principle of individualization, and the dose should be adjusted in time according to patients' responses, so as to avoid adverse reactions such as hypotension and bradycardia while protecting the organs. Moreover, more strictly designed clinical studies and in-depth mechanistic investigations are needed for the optimal dexmedetomidine therapy and better organ protection during the perioperative course. In order to facilitate better understanding of clinicians, this paper reviews the organ-protective effects and underlying mechanisms of dexmedetomidine.

关键词

右美托咪定器官保护麻醉围手术期

Keywords

dexmedetomidineorgan protectionanesthesiaperioperative period

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