国际麻醉学与复苏杂志   2021, Issue (3): 0-0
    
γ‑氨基丁酸能系统在麻醉药发挥抗抑郁作用中的研究进展
李冬雪1()
1.天津市第三中心医院麻醉科
Research progress on the use of γ‑aminobutyric acidergic system against depression
 全文:
摘要:

抑郁症是指在多种病因共同作用下,患者出现显著而持久的心境低落的情绪变化。γ‑氨基丁酸(γ‑aminobutyric acid,GABA)是哺乳动物中枢神经系统重要的抑制性神经递质,其含量及功能异常与抑郁症发病机制密切相关。因麻醉药物主要通过GABA受体发挥作用,丙泊酚、氯胺酮等麻醉药物在抗抑郁中使用范围逐渐扩大。文章主要阐述抑郁症与GABA能系统功能减退和GABA‑谷氨酸能系统失衡之间的关系,以及GABA与抑郁症患者神经内分泌紊乱的相互影响。在上述基础上进一步探讨静脉麻醉药(丙泊酚、依托咪酯)、氯胺酮、吸入麻醉药(异氟醚、七氟醚)和苯二氮    类镇静催眠药通过GABA能系统影响抑郁症的作用机制,为抑郁症患者提供治疗新靶点和围手术期麻醉药配伍新思路,以减少手术应激对抑郁症的不利影响。

关键词: 抑郁症; 麻醉药; γ‑氨基丁酸
Abstract:

Depression is caused by the interaction of multiple causes, where depressive patients show significant and persistent emotional changes. γ‑aminobutyric acid (GABA) is an important inhibitory neurotransmitter in the mammalian central nervous system, whose abnormal content and function are related to the pathogenesis of depression. Anesthetics exert their effects via GABA receptors. The use of propofol, ketamine and other anesthetics against depression gradually expanded. This article discussed the relationship between depression and dysfunctioned GABA‑ergic system and the imbalance of GABA‑glutamatergic system, as well as the interaction between GABA and neuroendocrine disorder in patients with depression. On the above discussion, the mechanisms by which intravenous anesthetics (propofol, etomidate) and ketamine, inhalation anesthetics (isoflurane, sevoflurane) and benzodiazepines exert their effects on depression through GABA‑ergic system were explored. These findings can provide new targets for the treatment and new thoughts for the compatibility of perioperative anesthetics, so as to relieve the adverse effects of surgical stress on depression.

Key words: Depression; Anesthetics; Gamma‑aminobutyric acid