麻醉药对发育中大脑神经毒性的研究进展

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摘要麻醉药物对发育中大脑的神经毒性备受关注，目前暂无有效证据说明动物实验结果与临床有相关性，但已有数据显示暴露于某些麻醉药后可引起短暂性的神经功能受损，从而影响大脑的发育。本文从麻醉药神经毒性机制、动物实验、临床研究、目前研究争论问题进行阐述，建议不要在大脑发育期接受手术，儿科麻醉中尽量避免使用多种麻醉药。

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	肖华平
	杨小敏

关键词 ：麻醉药, 发育中大脑, 神经毒性

Abstract：Anesthetic-induced neurotoxicity in developing brains has attracted extensive attention.There is no evidence that the results of animal experiments are relevant to the clinic,but researches data have shown that transient impairment of nerve function can be caused by exposure to certain anesthetics,which can affect the development of the brain.In this paper,the neurotoxicity mechanism,animal experiment,clinical research and current debate on anesthetics are discussed.It is advised not to undergo surgery during brain development.Multiple anesthetics should be avoided in pediatric anesthesia.

Key words： Anesthetic Developing brain Neurotoxicity

基金资助:江西省青年科学基金资助项目（20121522070038）

作者简介: 肖华平（1977-），男，博士，副主任医师，主要从事围术期认知功能研究

引用本文:

肖华平；杨小敏. 麻醉药对发育中大脑神经毒性的研究进展[J]. 中国当代医药, 2017, 24(35): 23-26.
XIAO Hua-ping；YANG Xiao-min. Study progress in anesthetic-induced neurotoxicity in developing brains. 中国当代医药, 2017, 24(35): 23-26.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2017/V24/I35/23

[1]	李国辉，薛庆生，罗艳，等.全身麻醉药致发育期大脑神经毒性:从基础到临床[J].中华医学杂志，2014，94（5）:397-399.
[6]	仪修文，李文献.全身麻醉药物对小儿发育中大脑的影响[J].国际麻醉学与复苏杂志，2014，35（5）:445-449.
[2]	Davidson AJ.Anesthesia and neurotoxicity to the developing brain:the clinical relevance[J].Paediatr Anaesth，2011，21（7）:716-721.
[3]	Mccann ME，Soriano SG.General anesthetics in pediatric anesthesia:influences on the developing brain[J].Curr Drug Targets，2012，13（7）:944-951.
[4]	WangC，JrSW.Strategiesandexperimental models for evaluating anesthetics:effects on the developing nervous system[J].Anesth Analg，2008，106（6）:1643-1658.
[5]	Loepke AW，Soriano SG.An assessment of the effects of general anesthetics on developing brain structure and neurocognitive function[J].Anesth Analg，2008，106（6）:1681.
[7]	ZhangX，XueZ，SunA.Subclinicalconcentrationofsevoflurane potentiates neuronal apoptosis in the developing C57BL/6 mouse brain[J].Neurosci Lett，2008，447（2-3）:109-114.
[8]	Fredriksson A，Pontén E，Gordh T，et al.Neonatal exposure to a combination of N-methyl-D-aspartate and gammaaminobutyric acid type A receptor anesthetic agents potentiates apoptotic neurodegeneration and persistent behavioral deficits[J].Anesthesiology，2007，107（3）:427-436.
[9]	Vutskits L，Gascon E，Potter G，et al.Low concentrations of ketamine initiate dendritic atrophy of differentiated GABAergic neurons in culture[J].Toxicology，2007，234（3）:216-226.
[10]	Mcclaine RJ，Uemura K，Sg DLF，et al.General anesthesia improves fetal cerebral oxygenation without evidence of subsequent neuronal injury[J].J Cereb Blood Flow Metab，2005，25（8）:1060-1069.
[11]	Li Y，Liang G，Wang S，et al.Effects of fetal exposure to isoflurane on postnatal memory and learning in rats[J].Neuropharmacology，2007，53（8）:942-950.
[12]	Loepke AW，Istaphanous GK，Miles L，et al.The effects of neonatal isoflurane exposure in mice on brain cell viability，adult behavior，learning，and memory[J].Anesth Analg，2009，108（1）:90-104.
[13]	Hintz SR，Kendrick DE，Stoll BJ，et al.Neurodevelopmental and growth outcomes of extremely low birth weight infants after necrotizing enterocolitis[J].Pediatrics，2005，115（3）:696-703.
[14]	Listed N.Surgery and the tiny baby:sensorineural outcome at 5 years of age.The Victorian Infant Collaborative Study Group[J].J Paediatr Child Health，1996，32（2）:167-172.
[15]	Dimaggio C，Sun LS，Kakavouli A，et al.A retrospective cohort study of the association of anesthesia and hernia repair surgery with behavioral and developmental disorders in young children[J].J Neurosurg Anesthesiol，2009，21（4）:286-291.
[16]	Kalkman CJ，Peelen L，Moons KG，et al.Behavior and development in children and age at the time of first anesthetic exposure[J].Anesthesiology，2009，110（4）:805-812.
[17]	Sprung J，Flick RP，Wilder RT，et al.Anesthesia for cesarean delivery and learning disabilities in a populationbased birth cohort[J].Anesthesiology，2009，111 （2）:302-310.
[18]	Flick RP，Katusic SK，Colligan RC，et al.Cognitive and behavioral outcomes after early exposure to anesthesia and surgery[J].Pediatrics，2011，128（5）:1053-1061.
[19]	Sprung J，Flick RP，Katusic SK，et al.Attention-deficit/hyperactivity disorder after early exposure to procedures requiring general anesthesia[J].Mayo Clin Proc，2012，87（2）:120-129.
[20]	Hansen TG，Pedersen JK，Henneberg SW，et al.Academic performance in adolescence after inguinal hernia repair in infancy:a nationwide cohort study[J].Anesthesiology，2011，114（5）:1076-1085.
[21]	Dimaggio C，Sun LS，Li G.Early childhood exposure to anesthesia and risk of developmental and behavioral disorders in a sibling birth cohort[J].Anesth Analg，2011，113（5）:1143-1151.
[22]	Young C，Jevtovictodorovic V，Qin YQ，et al.Potential of ketamine and midazolam，individually or in combination，to induce apoptotic neurodegeneration in the infant mouse brain[J].Br J Pharmacol，2005，146（2）:189-197.
[23]	Zhao X，Yang Z，Liang G，et al.Dual effects of isoflurane on proliferation，differentiation，and survival in human neuroprogenitor cells[J].Anesthesiology，2013，118（3）:537-549.
[24]	Zhong J，Yang X，Yao W，et al.Lithium protects ethanolinduced neuronal apoptosis[J].Biochem Biophys Res Commun，2006，350（4）:905-910.
[25]	Cabrera O，Dougherty J，Singh S，et al.Lithium protects against glucocorticoid induced neural progenitor cell apoptosis in the developing cerebellum[J].Brain Res，2014，1545:54-63.
[26]	Ma D，Williamson P，Januszewski A，et al.Xenon mitigates isoflurane-induced neuronal apoptosis in the developing rodent brain[J].Anesthesiology，2007，106（4）:746-753.