阿片类药物神经毒性的研究进展OA

Opioid-induced neurotoxicity(OIN)is a neuropsychiatric syndrome that occurs during opioid therapy.Its un-derlying mechanisms include:imbalance of the cholinergic and dopaminergic systems;effects on the synthesis and release of multiple neurotransmitters;activation of N-methyl-D-aspartate(NMDA)receptors;and accumulation of toxic opioid me-tabolites.The predominant clinical manifestations of OIN encompass cognitive impairment,delirium,myoclonus,and hyper-algesia,necessitating differential diagnosis from conditions with similar presentations.Therapeutic strategies include opioid dose reduction or discontinuation,switching to methadone,administration of ketamine,use of psychostimulants,correction of electrolyte disturbances,and fluid resuscitation.By systematically retrieving OIN-related literature from databases in-cluding SCI,GeenMedical,PubMed,ClinicalTrials,China National Knowledge Infrastructure(CNKI),and Wanfang Data,this article provides a comprehensive review of the current state of research on OIN,with the aim of facilitating effective clinical recognition and early intervention,thereby improving patients' quality of life.