纳美芬治疗急性脑卒中伴意识障碍患者血流动力学及血清强啡肽、S100β水平的临床观察  

Clinical observationof hemodynamics and serum levels of enkephalin and S100βin patients with acute stroke and disturbance of conscious-ness treated with Namepin

作　　者：孙嫄[1] 黄颖[1] 陈巍巍[1] 郝梦薇 李乐超 魏涛[1] 庞慧[2] SUN Yuan;HUANG Ying;CHEN Weiwei;HAO Mengwei;LI Le Chao;WEI Tao;PANG Hui(Department of Neurology,Xuzhou Central Hospital,Jiangsu)

机构地区：[1]徐州市中心医院神经内科,江苏徐州221000 [2]徐州市中心医院中心实验室,江苏徐州221000

出　　处：《中国急救复苏与灾害医学杂志》2021年第2期147-149,156,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：江苏省自然科学基金项目(编号:BK20190158);江苏省第十五批“六大人才高峰”高层次人才项目(编号:WSN270);江苏省青年医学人才项目(编号:QNRC2016383)。

摘　　要：目的探究纳美芬治疗急性脑卒中伴意识障碍对患者血流动力学及血清强啡肽(DanA_(1-13))β-内啡肽(β-EP)、S100β水平的影响。方法选取2017年7月-2019年12月徐州市中心医院收治的110例急性脑卒中伴意识障碍患者,按照随机数字表法分为观察组和对照组各55例,对照组采用安慰剂治疗,观察组采用盐酸纳美芬治疗,检测两组治疗前后血清DanA_(1-13)、β-EP、S100β水平、神经功能(NIHSS评分)、格拉斯哥昏迷评分(GCS)、脑部血流动力学变化、Barthel指数(BI),记录意识恢复时间、药物不良反应情况,并进行对比分析。结果治疗后检测两组DanA_(1-13)、β-EP、S100β水平均降低,且观察组低于对照组,差异具有统计学意义(P<0.05);治疗后观察组GCS评分高于对照组,自主意识恢复时间短于对照组,差异具有统计学意义(P<0.05);治疗后两组NIHSS评分均降低,BI评分均升高,且观察组改善更明显,差异具有统计学意义(P<0.05);治疗后两组大脑中动脉的平均流速均升高,且观察组高于对照组,PIRI均下降,且观察组低于对照组,差异具有统计学意义(P<0.05);两组不良反应发生率无显著差异(P>0.05)。结论纳美芬治疗急性脑卒中伴意识障碍患者能明显改善患者血流动力学,降低血清强啡肽、S100β水平,是一种较为安全有效的治疗方法。Objective To investigate the effect of nalmefene for acute stroke and disturbance of consciousness on he-modynamics and serum dynorphin(Dan_(1-13)),β-endorphin(β-EP),and S100βlevels of.Methods Between July 2017 and December 2019,110 patients with acute stroke and disturbance of consciousness admitted to our hospital were enrolled and divided into observation group and control group according to random number table with 55 cases in each group.The control group was treated with placebo,and the observation group was trealed with nalmefene hy-drochloride.Serum DanA_(1-13),β-EP,S100βlevels,neurological function(NIHSS score),Glasgow coma score(GCS),cerebral hemodynamic changes,Barthel index(BI)were measured.The time of consciousness recovery and adverse drug reactions were recorded to perform comparative analysis.Results After treatment,the levels of DanA1-13,β-EP,and S100βin the two groups were decreased,and the observation group was lower than the control group(P<0.05).The GCS score of the observation group was higher than the control group after treatment,and the recovery time of autonomic consciousness was shorter than that of the control group(P<0.05).After treatment,the NIHSS scores of the two groups decreased,but the BI scores increased,and the observation group improved more signifi-cantly(P<0.05).After treatment,the average flow velocity of the middle cerebral arteries in both groups increased,and the observation group was higher than the control group;PI and RI were decreased,and the observation group was lower than the control group(P<0.05).There was no significant difference in adverse reaction rates between the two groups(P>0.05).Conclusions Nalmefeneis a safe and effective treatment for patients with acute stroke and dis-turbance of consciousness,which can significantly improve hemodynamics and reduce serum dynorphin and S100βlevels.

关 键 词：纳美芬 强啡肽 急性脑卒中 血流动力学 

分 类 号：R453.9[医药卫生—治疗学]