去甲肾上腺素在脊髓背角的镇痛机制

疹髓背角浅层是传递和调制外周伤害性信息的关键部位。起源于脑干的去甲肾上腺素（NA）能纤维终止脊髓背角,它们释放的NA具有抑制初级传入末梢释放谷氨酸和P物质、增加Ⅱ层（胶状质）抑制性神经活性物质释放的作用。此外,形态学研究提示NA可能直接抑制Ⅰ/Ⅲ层向丘脑传递伤害性信息的投射神经元。NA可能通过以上途径,实现对外周伤害性信息传递的调制而发挥镇痛作用。

Analgesic mechanisms of noradrenaline in the spinal dorsal horn

The superficial laminae of the spinal dorsal horn play important roles in nociceptive transmission and modulation. Noradrenergic fibers originated from brainstem pain-control system terminate and release noradrenaline (NA) in the superficial dorsal horn. The released NA might take part in the modulation of nociceptive transmission through the following pathways: (1) inhibits the glutamate and substance P release from primary afferent terminals; (2) increases the release of inhibitory neurotransmitters from lamina II (substantia gelatinosa) neurons. Morphological findings also raise the possibility that NA directly inhibits projection neurons in laminae I/III which convey the nociceptive information to the thalamus, thus inhibit nociceptive transmission at spinal level.