肝性脑病患者血浆β-内啡肽变化及纳络酮治疗作用研究  

STUDY ON THE CHANGE IN SERUM β-ENDORPHIN IN PATIENTS WITH HEPATIC ENCEPHALOPATHY AND THE THERAPEUTIC EFFECT OF MALOXONE

作　　者：孔宪牛[1] 马健民[1] 

机构地区：[1]山东省临沂市人民医院传染病科

出　　处：《山东医科大学学报》2001年第1期42-45,共4页Acta Academiae Medicinae Shandong

基　　金：山东省卫生厅资助课题

摘　　要：目的 :观察肝性脑病患者血浆β内啡肽 ( β EP)浓度变化及纳络酮治疗肝性脑病的疗效。方法 :采用放射免疫分析法测定 53例肝性脑病患者血浆β EP含量。纳络酮治疗Ⅱ级以上肝性脑病 2 0例 ,并与对照组 2 0例比较 ,观察清醒时间、清醒率、病死率等。结果 :肝性脑病患者血浆β EP含量 ( 76 53±2 4 .13pg/ml)显著高于对照组 ( 2 4 31± 15.2 4 pg/ml) (t =2 .4 1,P <0 .0 2 )和无脑病组 ( 35 4 1± 16.87pg/ml) (t =2 .38,P <0 .0 2 )。无脑病组及肝性脑病Ⅰ级与对照组差异无显著性 (t =1.32及 1 89,P >0 0 5)。用纳络酮治疗后 ,治疗组清醒时间平均 ( 15 56± 13 84 )h ,对照组 ( 32 2 7± 19.31)h(t =2 .7,P <0 .0 1) ;治疗组 3d清醒率 85% ,对照组 55% ,差异有显著性 ,( χ2 =4 .2 8,P <0 .0 5) ,病死率差异无显著性。结论 :肝性脑病患者血浆β EP较正常人显著升高 ,其升高水平与脑功能障碍程度一致 ,提示β EP在肝性脑病发生及发展过程中起作用。纳络酮治疗肝性脑病有促清醒作用。Objective:To study the change of plasma β endorphin (β EP) in patients with hepatic encephalopathy(HE) and its clinical significance and observe the effect of Maloxone in the treatment of HE. Methods:Serum β EP levels were determine with radioimmunoassay.Maloxone were used to treat the patients with HE by intramuscular or intravenous injection.0.4～0.8mg Maloxone were used each time,one treatment cause was 3 days.The time when patients came to,sober minded rates and mortality et al were recorded.Results:The average level of serum β EP in patients with HE(76.53±24.13pg/ml) was significantly higher than that in healthy people(24.31±15.24pg/ml)(t=2.41,P<0.02).It was higher than that in patients in sober minded period too(35.41±16.87pg/ml)(t=2.38,P<0.02).But there was no defference in comparing patients without HE and with HE I grade(45.64±12.32pg/ml) to healthy people(t=1.32 and 1.89,P>0.05).After patients with HE were treated with maloxone,the average time patients needed to come to was (15.56±13.84) hours,while in control group it was (32.27±19.31) hours,the defference was significant between them(t= 2.79 ,P<0.01).The sober minded rate in treated group was 85%,in controlled group it was 55%(χ 2=4.28,P<0.05),but there was no significant defference in mortality between them(χ 2=0.9,P>0.25).Conclusion:The serum levels of β EP in patients with HE were significant higher than that in patients without HE or healthy people.They increased following the injured degree of brain function.That indicate β EP performed an important affect in occurrence and development of HE,Maloxone peformed analeptic affect.So it has clinical value in treating patients with HE.

关 键 词：肝性脑病 Β-内啡肽 纳络酮 治疗 疗效 

分 类 号：R747.905[医药卫生—神经病学与精神病学]