不同剂量纳洛酮治疗进展型脑梗死的临床对比研究  

Clinical comparative study of different doses of naloxone in the treatment of patients with progressive cerebral infarction

作　　者：吴滨[1] 翁雪莉[1] 钱达元[1] 

机构地区：[1]杭州师范大学附属医院神经内科,310015

出　　处：《中华危重症医学杂志（电子版）》2010年第2期24-27,共4页Chinese Journal of Critical Care Medicine:Electronic Edition

摘　　要：目的初步探讨不同剂量纳洛酮在治疗进展型脑梗死(CI)患者的量效关系。方法将132例进展型CI患者分为纳洛酮小剂量治疗组(A组,62例)和纳洛酮大剂量治疗组(B组,70例),均在常规治疗的基础上,早期分别给予不同剂量纳洛酮治疗,动态监测患者病情和血浆β-内啡肽(β-EP)的变化,并根据治疗前和治疗后15d时神经功能缺损评分值的变化情况判定疗效。结果 B组患者治疗5d后血浆β-EP含量明显低于A组,差异有统计学意义(P<0.01)。B组患者在治疗15d后的神经功能缺损评分值低于A组,差异有统计学意义(P<0.05)。此外,根据神经功能缺损评分值的变化情况,A组的治疗有效率为79.0%(49/62),而B组的治疗有效率为91.4%(64/70),差异有统计学意义(P<0.05)。结论早期、大剂量纳洛酮治疗能更有效地提高进展型CI患者的临床疗效,促进神经功能恢复。Objective To investigate the dose-effect relationship of naloxone in the treatment of patients with progressive cerebral infarction （CI）. Methods One hundred and thirty-two patients with progressive CI were randomly assigned into small-dose naloxone group （A group, 62 cases） and large-dose naloxone group （B group,70 cases）. On the basis of routine measures, different doses of intravenous naloxone were administered immediately in the patients with progressive CI. Scores of nervous function defect and plasma β-endorphin （β-EP） were dynamically monitored and compared. Results On the 5th d of treatment, plasma β-EP of B group was lower than that of A group （P〈0.01）. On the 15th d of treatment, the score of nervous function defect in B group was lower than A group （P〈0.05）. Furthermore, the significant effective rate was 79.0% （49/62） in A group and 91.4% （64/70） in B group, according to the score of nervous function defect （P〈0.05）. Conclusion The curative effect on the patients with progressive CI can be further improved by administration of early large dose naloxone intravenous injection.

关 键 词：脑梗死 纳洛酮 内啡肽 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]