摘要氯胺酮单次滴注有7~10天的持续抗抑郁和显著降低自杀风险效应,但其具体机制尚不明确.本文对氯胺酮持续抗抑郁效应机制进行综述,发现氯胺酮可调控睡眠节律、突触修剪分子通路以及难治性抑郁相关神经环路变化,该作用可能与其持续抗抑郁效应关联.未来的研究方向是通过小动物在体成像和影像遗传学技术,揭示氯胺酮持续抗抑郁的遗传、分子机制及影像特征,探寻最佳用药时间点,为增强其抗抑郁持续效应提供精准科学依据.

abstractsA single infusion of ketamine has sustained antidepressant effects and significantly de-creases the risk of suicide,and the effects can last up for 7-10 days,but the underlying mechanism is un-clear. The mechanism was reviewed underlying the antidepressant effects of ketamine,and found that ket-amine may exert its antidepressant effect by regulating sleep/wake cycle,synaptic pruning,molecular path-ways,and neural circuits for treatment-refractory depression. Further studies are needed to investigate the ge-netic,molecular mechanisms underlying the sustained antidepressant effect of ketamine,and the associated imaging findings through in vivo imaging of animals and imaging genetics techniques,explore the optimal time for administration of ketamine,and then provide accurate scientific basis for enhancing its anti-depressant effect.