β-内啡肽在早产儿原发性呼吸暂停发病中的作用及纳洛酮疗效观察

Plasma beta-endorphin concentration and Naloxone treatment in primary apnea of prematurity

目的 探讨 β 内啡吠 (β EP)在早产儿原发性呼吸暂停 (primaryapneaofprematurity ,AOP)发病机制中的作用及纳洛酮 (NX)的治疗效果。方法 应用放射免疫法测定 2 1例原发性AOP患儿血浆 β EP含量 ,与 30例 (胎龄、日龄具有可比性 )的无呼吸暂停的早产儿作对照。并将 2 1例患儿随机分为NX治疗组和氨茶碱治疗组 ,比较两组治疗前后血浆 β EP含量变化及疗效和不良反应。 结果 2 1例原发性AOP患儿血浆 β EP水平明显高于对照组 ,差异有显著性 (P <0 0 5 )。NX组和氨茶碱组治疗后的血浆 β EP浓度均明显下降 ,与治疗前比较差异有显著意义 (P <0 0 5 ) ;治疗后两组血浆 β EP比较 ,NX组低于氨茶碱组 ,差异有显著性 (P <0 0 5 )。NX组与氨茶碱组治疗的总有效率分别为 81%与80 % ,两者比较差异无显著性 (P >0 0 5 )。NX组未见药物不良反应。结论 β EP可能是原发性AOP的发病因素之一。NX和氨茶碱的疗效相似 ,但未发现治疗不良反应 。

Objective To explore the causitive role of β-endorphin and curative effects of Naloxone in primary apnea of prematurity(AOP).Methods With the technique of radioimmuoassay,the plasmaβ-endorphin level was measured in premature infants with apnea(n=21),compared with the control group that without apnea(n=30).Twenty one patients with apnea of prematurity(AOP) were randomly divided into two groups:the group treated with naloxone and the other group treated with aminophylline.Plasma samples were taken 1h prior to treatment and 72h post-treatment.Results The β-endorphin levels were significantly higher in infants with apnea than those in control group(P<0.05).The β-endorphin levels were significantly decreased after both NX and aminophylline treatment (P<0.05).Futhermore,β-endorphin levels were significantly decreased in NX group than the aminophylline group 72 hours after treatment (P<0.05).There was no difference in the effectiveness between the naloxone and aminophylline group(P>0.05).No adverse effects were found in neonates treated with naloxone.Conclusion β-endorphin plays a role in the pathophysiology of apnea of prematurity,and naloxone has some curative effects.