右美托咪定对麻醉药的基因毒性有保护作用？

本文由“小麻哥的日常”授权转载

摘要译文（供参考）

右美托咪定输注对急诊手术患者异氟醚基因毒性的保护作用 背景： 异氟醚（ISO）已广泛用于全身麻醉，据报道在长时间的手术过程中会导致脱氧核糖核酸（DNA）损伤。

右旋美托咪定（DEX）是一种肾上腺素能激动剂，具有抗氧化活性，可降低ISO在接受大的神经外科手术的患者中引起的遗传毒性（DNA损伤）和氧化应激。

方法： 24名ASA（美国麻醉医师协会）I级和II级患者随机分为两组（n=12）。 A组患者接受ISO，B组患者接受DEX输注以维持麻醉。 在不同时间间隔采集静脉血样，用于评估氧化应激标志物丙二醛（MDA）和内源性抗氧化剂超氧化物歧化酶（SOD）和催化酶（CAT）。

采用单细胞凝胶电泳（SCGE）彗星试验（因其细胞电泳形状颇似慧星而得名，编者注）研究ISO的遗传毒性。

结果： B组抗氧化剂水平升高，MDA和遗传损伤指数降低（P<0.001），且呈时间依赖性。 与阴性对照组或DEX输注后的基线值相比，遗传损伤在T2点最高（0.77 vs.1.37），并持续下降至T3（0.42 vs.1.19）。 与B组相比，A组血清中的MDA水平显著升高（P<0.001）（1.60±0.33 vs.0.03±0.001）。

B组CAT和SOD的酶活性显著高于A组（10.11±2.18 vs.5.71±0.33），分别为1.04±0.05 vs.0.95±0.01）。

结论：

它可能在日常麻醉实践中发挥作用，并改善对患者和麻醉人员的毒性作用。

试验注册： 拉合尔总医院研究生医学院（PGMI）伦理委员会于2019年2月4日批准在本研究中使用人类，人类受试者申请编号为ANS-6466。

此外，由于临床试验需要从世界卫生组织（WHO）批准的适当注册处进行注册，该试验也于2021 12月30日在泰国临床试验注册处（世界卫生组织批准的临床试验注册登记处）进行了回顾性注册，注册号为TCTR20211230001。

原文摘要

Protective Effects of Dexmedetomidine Infusion on Genotoxic Potential of Isoflurane in Patients Undergoing Emergency Surgery 

Background:  Isoflurane (ISO) has been extensively uses in general anesthesia and reported to cause deoxyribonucleic acid (DNA) damage in prolonged surgical procedures. Dexmedetomidine (DEX) is an adrenergic agonist and having antioxidant activity that may reduce the genotoxic potential (DNA damage) and oxidative stress induced by ISO in patients undergoing major neurosurgical procedures.  

Methods and Findings.  Twenty-four patients of ASA (American Society of Anesthesiologists) classes I and II were randomly divided into two groups (n = 12).  Group A patients received ISO, while group B patients received DEX infusion for maintenance of anesthesia.  Venous blood samples were collected at different time intervals and used to evaluate the oxidative stress marker malondialdehyde (MDA) and endogenous antioxidants superoxide dismutases (SOD) and catalases (CAT).  A single-cell gel electrophoresis (SCGE)-comet assay was used to investigate the genotoxic potential of ISO. 

Conclusion:  Increased level of antioxidants and decreased value of MDA and genetic damage index were seen in group B (P < 0.001) in a time-dependent manner.  Genetic damage was highest at point T 2 (0.77 vs. 1.37), and continued to decrease till T 3 (0.42 vs. 1.19), with respect to negative controls or baseline values following DEX infusion.  Significantly, higher level of MDA was recorded in serum of group A (P < 0.001) as compared to group B (1.60 ± 0.33 vs. 0.03 ± 0.001).  Enzymatic activities of CAT and SOD were significantly higher in group B than group A (10.11 ± 2.18 vs. 5.71 ± 0.33), (1.04 ± 0.05 vs. 0.95 ± 0.01), respectively.  It may play a contributing role in daily anesthesia practice and improve the toxic effects on patients as well as anesthesia personnel.  

Trial Registration.  Ethical Committee of Post Graduate Medical Institute (PGMI), Lahore General Hospital approved the use of humans in this study vide human subject application number ANS-6466 dated February 04, 2019. Furthermore, as the clinical trials required registration from an appropriate registry approved by World Health Organization (WHO), this trail also retrospectively registered at Thai Clinical Trials Registry (an approved WHO registry for clinical trials registration) under reference ID TCTR20211230001 on December 30, 2021.

免责声明：

文中所涉及药物使用、疾病诊疗等内容仅供医学专业人士参考。

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编辑：MiSuper.米超

校对：Michel.米萱    

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