Brit J Anaesth:氩气和氙气治疗获得性脑损伤的疗效

2022-06-11 MedSci原创 MedSci原创

这些结果为氙气和氩气作为获得性脑损伤的神经保护治疗提供了证据。目前的证据表明,氙气总体上比氩气更有效。

获得性脑损伤(ABIs)是世界范围内发病率和死亡率的主要来源。ABI可以由创伤性损伤(道路事故、意外摔倒、运动损伤、暴力)或缺血性脑损伤(缺血性卒中、继发于心脏骤停的脑缺血(CA)、体外循环后的神经损伤(CBP)、围产期缺氧缺血性脑病)所引起。ABI患者即使是轻微的头部损伤或轻微的卒中,也会表现出一系列的认知、运动和情绪症状,如头痛、头晕、疲劳、易怒、注意力不集中、睡眠障碍、记忆缺陷、恶心、焦虑和抑郁。氩气和氙气是治疗获得性脑损伤潜在的新型神经保护疗法。氙气已经在治疗缺血性脑损伤方面进行了早期临床试验,结果好坏参半。氩气作为一种治疗脑损伤的药物尚未进入临床试验阶段。

近日,麻醉学领域权威杂志British Journal of Anaesthesia上发表了一篇研究文章,研究人员旨在综合氩和氙作为脑损伤神经保护疗法的临床前研究的结果。

在系统回顾MEDLINE和Embase数据库后,研究人员进行了两两分层的荟萃分析。采用亚组分析、漏斗图不对称和Egger’s回归检验了研究的异质性。

该分析共确定了32项研究,其中14项是氩气研究,18项是氙气研究,涉及1384只动物的测量,包括小鼠、大鼠和猪模型。脑损伤模型包括心脏骤停后缺血性脑损伤(CA)、体外循环后神经系统损伤(CPB)、创伤性脑损伤(TBI)和缺血性脑卒中。氩气、氙气均有显著性(P<0.001),神经保护效应大小均为正性作用。氩气(CA、TBI,脑卒中)的总效应量为18.1%(95%可信区间[CI]为8.1-28.1%),氙气(CA、TBI、脑卒中)的总效应量为34.1%(95%CI为24.7-43.6%)。在纳入CPB的模型中,仅氙气有效,氙气效应大小(CPB、CA、TBI、卒中)为27.4%(95%CI为11.5-43.3%)。与氩气相比,氙气的保护作用显著(P<0.001)。

由此可见,这些结果为氙气和氩气作为获得性脑损伤的神经保护治疗提供了证据。目前的证据表明,氙气总体上比氩气更有效。

原始出处:

Min Liang. et al. A preclinical systematic review and meta-analysis of the noble gases argon and xenon as treatments for acquired brain injury.British Journal of Anaesthesia.2022.https://www.bjanaesthesia.org/article/S0007-0912(22)00198-2/fulltext

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