纳络酮治疗肺性脑病昏迷的临床对比研究  

Controlled study of Naloxone in treatment of pulmonary encephalopathy patients with coma

作　　者：史习勤[1] 郑明芳[1] 徐侃[1] 贡伟[1] 赵冰清[1] 葛晓麟[1] 

机构地区：[1]上海交通大学附属第一人民医院急诊科,200080

出　　处：《上海医学》2004年第6期409-410,共2页Shanghai Medical Journal

摘　　要：目的　观察 β 内啡肽特异性拮抗剂纳络酮治疗肺性脑病昏迷的苏醒疗效。 方法　 6 5例肺性脑病昏迷患者随机分为治疗组 (33例 )和对照组 (32例 ) ,对照组仅予综合治疗 (吸氧、抗感染、平喘、肾上腺糖皮质激素、呼吸兴奋剂等 ) ,治疗组在此基础上加用纳络酮 2～ 8mg/d。比较两组清醒前、后血气分析值、清醒所需时间和病死率。结果　治疗组清醒前、后动脉血氧分压 (PaO2 )和动脉血二氧化碳分压 (PaCO2 )值的差异无显著性(t =0 .95和 1.36 ,P值均 >0 .0 5 ) ;与对照组相比 ,治疗组清醒所需时间明显缩短 (t=34.5 5 ,P <0 .0 5 ) ,病死率明显下降 (χ2 =5 .18,P <0 .0 5 )。结论　纳络酮对肺性脑病昏迷具有苏醒作用 ,其机制与综合治疗后清醒的机制不同。该药在肺性脑病昏迷的治疗方面具有一定临床应用价值。Objective To observe the awakening effect of naloxone, a specific antagonist of β-endorphin in pulmonary encephalopathy patients with coma. Methods 65 cases of pulmonary encephalopathy patients with coma were randomly divided into treated and control groups. The treated group was given intravenous naloxone at a dosage of 2～8 mg/d together with comprehensive therapy (oxygen inhalation, antibiotics, bronchodilators, corticosteroid and respiratory stimulants, etc); the control group received comprehensive therapy only. A comparison was made between the two groups on: ①the time required for awakening; ②blood gas analysis before and after awakening; ③the mortality rates. Results In the treated group, there were no significant differences in PaO 2 and PaCO 2 before and after awakening, being t=0.95 and t=1.36 respectively, P>0.05. The time required for awakening was shortened significantly (t=34.55, P<0.05). The mortality rate reduced obviously(χ 2=5.18, P<0.05). Conclusion Naloxone possesses awakening effect for the comatous pulmonary encephalopathy patients. The mechanism is quite different from that occurs in those receiving comprehensive therapy only.

关 键 词：纳络酮 治疗 肺性脑病昏迷 临床对比研究 

分 类 号：R747.9[医药卫生—神经病学与精神病学]