纳络酮治疗新生儿缺氧缺血性脑病机理探讨

Mechanism study on newborn hypoxic-ischemic encephalopathy with naloxone therapy

目的探讨纳络酮治疗新生儿缺氧缺血性脑病(HIE)的临床疗效及血清β-内啡肽(β-EP)和脂质过氧化物代谢产物丙二醛(MDA)的变化。方法将60例新生儿随机分为纳络酮组与常规治疗组各30例,纳络酮组在常规治疗的基础上加纳络酮0.3mg静脉滴注,每日1次,连用3天,两组在观察临床疗效的同时,均于治疗前及疗程结束后分别采取股静脉血进行检验。结果纳络酮治疗组治疗后血β-EP、MDA含量均明显降低,而对照组变化不明显(P<0.05)。临床疗效亦优于对照组(P<0.05)。结论纳络酮治疗HIE可能通过阻滞阿片样受体及清除氧自由基,从而减轻缺氧缺血性脑水肿及脑损害,提高治愈率,降低病残率。

Objective To observe clinical effect and changes of serum betaendorphin(β-Ep) and malonic dyadic aldehyde(MDA) of newborn hypoxicischemic encephalopathy(NHIE) treated with naloxone.Methods 60 patients of NHIE were divided as the treating group (30 patients) and the control group(30 patients)randomly.The treating group was additionally treated with naloxone 0.3mg intravenous drip qd for 3 days. Concentrations of β-EP and MDA were detected on blood samples from femoral veins before and after the treatment.Results Compared with the control group,densities of β-EP and MDA were markedly descendent in the treating group after the treatment(P<0.05),and the therapeutic effect was obviously advantageous in the treating group(P<0.05).Conclusion Naloxone can reduce encephaledema and celebral lesion,increase the cure rate,decrease the disability rate might be associated with blooking opiate receptor and cleaning oxyradical when it is used in NHIE.