目的 探讨功能性消化不良(FD)患者抗抑郁治疗初期出现胃肠道不良反应的机制,评价抗抑郁药物在FD治疗中的安全性.方法 将57例FD患者随机分为两组,研究组30例和对照组27例.前者给予SSRIs治疗,后者给予噻奈普汀治疗,于治疗后统计两组胃肠道不良反应的类型及发生率,并了解两种药物胃肠道不良反应与疗程的关系.结果 研究组胃肠道不良反应发生率明显高于对照组,且多发生于治疗早期,随着治疗时间的延长,不良反应症状逐渐减轻.结论 选择性5-羟色胺再摄取抑制剂(SSRIs)是一种新型的抗抑郁药,胃肠道不良反应的发生与胃肠道内环境的5-羟色胺浓度骤然增加有关,后者作用于胃肠道5-羟色胺受体亚型,引起各种胃肠道不良反应.

Objective To investigate the mechanism of gastrointestinal adverse reaction in the early antidepressant treatment of functional dyspepsia(FD) and evaluate the safety of antidepressant in the treatment of FD.Methods Fifty-seven FD patients were divided into two groups randomly,30 cases in the study group and 27 cases in the control group.The patients in study group were given selective serotonin reuptake inhibitors(SSRI),the patients in control group were given Tianeptine.The types and incidence of gastrointestinal adverse reaction were recorded and analyzed,meanwhile the relationship between gastrointestinal adverse reaction and the period of treatment was understanded.Results The incidence of gastrointestinal adverse reaction in the study group was obviously higher than that in the control group,and mostly happened in the earlier treatment.As the treatments going,the gastrointestinal adverse reaction reduced gradually.Conclusions SSRIs is a new antidepressant drug.In the treatments,su

帕金森病(Parkinson''s disease)是一种慢性进展的中枢神经系统变性疾病,临床上以静止性震颤、运动减少、肌张力障碍和步态异常为特点.罗替戈汀是当前治疗帕金森病的新型药物之一,为非麦角类多巴胺受体激动剂,可以结合多巴胺D1到D5受体以及五羟色胺1A受体,但是对D3受体的亲和力和激动作用最高[1].罗替戈汀透皮贴剂是第一个非麦角类多巴胺受体激动剂贴剂[1],每日给药1次就能够在24 h中提供稳定的血浆药物浓度.罗替戈汀透皮贴在欧洲和北美已经被批准用于帕金森病的治疗,在国内尚处于临床试验阶段.多个大型的多中心、双盲、随机、对照研究均显示,罗替戈汀对能明显改善帕金森病的运动症状,并且对帕金森病的非运动症状有一定改善作用[2].

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化疗相关性恶心呕吐（ CINV）严重影响肿瘤患者的生活质量。随着止呕药物的发展，急性、延迟性CINV的控制率较前已有明显升高，但延迟性CINV的控制率仍偏低。第1代5-羟色胺3（5-HT3）受体拮抗剂对延迟性CINV的控制率并不优于单用地塞米松、甲氧氯普胺和丙氯拉嗪。最近研究表明第2代5-HT3受体拮抗剂帕洛诺司琼、神经激肽1受体拮抗剂在控制延迟性CINV方面上优于第1代5-HT3受体拮抗剂，当其联合抗精神病药物如奥氮平、丙氯拉嗪等可明显提高延迟性CINV的控制率。本文对延迟性化疗相关性恶心呕吐的治疗进展作一综述。

Chemotherapy-induced nausea and vomiting( CINV) is associated with a significant deterioration in quality of life. With the development of antiemetic drugs, the control rate of acute and delayed CINV has significantly improved,but the control rate of delayed CINV is still low. The effect of first generations of 5-hydroxytryptamine-3(5-HT3) receptor antagonists are not significantly su-perior to dexamethasone, metoclopramide or prochlorperazine alone in the control of delayed CINV. Recent studies have shown that pal-onosetron, the second generation of 5-HT3 receptor antagonists, and NK-1 receptor antagonists are better than the first generation of 5-HT3 receptor antagonists in the prevention of delayed CINV. Combination with antipsychotics drugs such as olanzapine, prochlorperazine can effectively control delayed CINV.

上气道扩张肌在维持上气道开放中起到重要作用,其中颏舌肌为典型的上气道扩张肌.阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea and hypopnea syndrome,OSAHS)主要表现为在睡眠过程中反复出现上气道塌陷,导致在睡眠中反复出现呼吸暂停和(或)低通气,引起低氧血症、高碳酸血症等一系列病理生理改变的综合征.目前已发现OSAHS患者觉醒时存在颏舌肌中枢代偿.中缝核5-羟色胺1受体(5-HT1受体)可能参与介导颏舌肌的中枢调控.

Upper airway dilator muscles play an important role in maintaining upper airway open,while the genioglossus is an important one of upper airway dilator muscles.Obstructive sleep apnea and hypopnea syndrome (OSAHS) is a disease characterized by frequent episodes of upper airway collapse during sleep,which results in a series of pathophysiological changes such as intermittent hypoxemia with/ without hypercapnia.Currently,it has been discovered that there exists central compensation of genioglossus in OSAHS patients during wakefulness.Raphe nucleus 5-hydroxytryptamine 1 receptor probably involves in the central control of genioglossus.

背景 5-羟色胺3(5-HT3)受体拮抗剂特别是第2代5-HT3受体拮抗剂帕洛诺司琼对术后恶心呕吐(postoperative nausea and vomiting,PONV)具有较好的预防作用,其药理学机制及临床应用状况近年来有了较为深入的研究和临床应用.目的 分析总结帕洛诺对各类手术PONV的预防效果及其作用机制.内容 第2代5-HT3受体拮抗剂帕洛诺司琼具有高度亲和性、长效性、副作用少等优点,通过阻断5-HT3与外周或中枢神经元的5-HT3受体结合,阻断迷走神经传入呕吐中枢和第四脑室化学感受区触发带,抑制呕吐反射,临床应用其预防PONV的高效性不断得到认可. 趋向 深入探讨其药理机制、副作用、预防PONV的临床应用等方面,以供临床工作者更加合理地应用其预防PONV.

Background The 5-HT3 antagonist,especially the second-generation of 5-HT3 antagonist palonosetron shows better efficacy against postoperative nausea and vomiting (PONV),its pharmacological mechanism and clinical efficacy were further investigated.Objective This paper sums up litures on its pharmacological mechanism and clinical efficacy on PONV prophylaxis.Content The second-generation 5-HT3 antagonist palonosetron has properties of greater receptor affinity,prolonged duration of action and few adverse effects.It blocks serotonin binding at vagal afferents in the gut and in the regions of the CNS involved in emesis,including the chemoreceptor trigger zone and the nucleus tractus solitarii,inhibits and emesis reflex,the high efficacy of palonosetron is being recognized.Trend This review summarizes its pharmacological mechanism of action,adverse effects,and clinical application on prevention of PONV,offering clinical reference to clinician to prevent PONV more reasonably.