脑出血患者血浆和脑脊液中阿片肽含量及纳络酮的影响  

Opioid peptide content in the plasma and cerebrospinal fluid of patients with cerebral hemorrhage and effect of naloxone on it

作　　者：关雪莲[1] 和梅[1] 刘永刚[1] 侯丽淳[1] 王复新[1] 王明礼[1] 

机构地区：[1]佳木斯大学附属第一医院神经内科,黑龙江佳木斯154003

出　　处：《黑龙江医药科学》2005年第6期7-8,共2页Heilongjiang Medicine and Pharmacy

基　　金：黑龙江省卫生厅科研立项基金资助(No2004-006)

摘　　要：目的:探讨脑出血患者血浆和脑脊液中β-内啡肽(-βEP)、强啡肽A1-13(D ynA1-13)和亮氨酸脑啡肽(L-ENK)的含量变化及纳络酮对其影响。方法:将60例脑出血(ICH)患者随机分为对照组(n=30)和纳络酮组(n=30)。对照组采用常规治疗,纳络酮组在常规治疗基础上加用纳络酮3.0m g/d静脉滴注,两组均治疗14d。采用放射免疫分析法(R IA),检测60例脑出血患者发病当天(治疗前)和治疗14d血浆和脑脊液中-βEP、D ynA1-13、L-ENK的含量变化,并与正常组比较。脑出血患者治疗前后进行神经功能缺损程度评分(NDS)。结果:(1)脑出血患者血浆和脑脊液中-βEP、D ynA1-13含量在发病后即明显增高,与正常组比较差异有显著性(均P<0.01);(2)脑出血患者血浆和脑脊液中-βEP、D ynA1-13、L-ENK含量,治疗结束后两组比较差异有显著性(P<0.05或P<0.01);(3)治疗结束后纳络酮组患者神经功能缺损程度评分与对照组比较差异有显著性(P<0.05)。结论:(1)脑出血后血浆和CSF阿片肽含量异常升高;(2)纳络酮能拮抗阿片肽的异常升高,具有脑保护作用。Objective： To explore the β- endorphin （β- EP）, dynorphinA1-13 （DynA1-13） and leu- enkephalin （L-ENK） levels in the plasma and cerebrospinal fluid （CSF）of patients with cerebral hemorrhage, and the effect of naloxone on them. Methods：The sixty patients with cerebral hemorrhage were randomly divided into 2 groups： control group （n = 30）and naloxone-treated group （n = 30）. The control group received 14-day routine treatment and the naloxone-treated group received 14- day naloxone treatment intravenousl （3.0 mg/d）besides routine treament. We measured the concentrations of -EP, DynA1-13 and L-ENK of 60 patients with cerebral hemorrhage during the acute stage before treatment and at 14 day after treatment by RIA and compared with those of normal group （the patients were treated by operations）. The scores of NDS before and after treatment were examined at the same time. Results： （1） The levels of β-EP and DynA1-13 in the plasma and CSF of patients with cerebral hemorrhage were obviously higher after its onset than those of the normal group（ P 〈 0.01 ） ; （2） There were significant differences between the levels of β-EP, DynA1-13and L-ENK in the plasma and CSF of patients with cerebral hemorrhage after the treatment （ P 〈 0. 05 or P 〈 0. 01 ）. （3） The scores of NDS of naloxone-treated group showed a significant difference compared with those of control group after the treatment（ P 〈 0.05 ）. Conclusion： （1） The content of opioid peptide in the plasma and CSF obviously increased immediately after intracerebral hemorrhage; （2） Naloxone can resist the abnormal elevation of opioid peptide ,with the function of protecting the brain.

关 键 词：脑出血 纳络酮 阿片肽 

分 类 号：R651.12[医药卫生—外科学]