肿瘤药学2026，Vol.16Issue(3)：288-299,12.DOI:10.3969/j.issn.2095-1264.2026.03.05
阿片类药物神经毒性的研究进展
Advances in opioid-induced neurotoxicity
摘要
Abstract
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.关键词
阿片类药物神经毒性/作用机制/鉴别诊断/临床症状/治疗措施Key words
Opioid-induced neurotoxicity/Mechanism of action/Differential diagnosis/Clinical manifestations/Thera-peutic strategies分类
医药卫生引用本文复制引用
李文斌,杨春,陶孝雯,周行,陈燕,程凯..阿片类药物神经毒性的研究进展[J].肿瘤药学,2026,16(3):288-299,12.基金项目
四川省医院协会青年药师专项科研项目(YP2202415). （YP2202415）
