大剂量纳络酮治疗脑出血的临床研究

A clinical trial of high-dose Naloxone in the treatment of cereb ral hemorrhage

目的 观察大剂量纳络酮对脑出血的疗效及安全性。方法 对 86例脑出血患者进行随机分组 ,大剂量治疗组 (试验组 ) 4 0例 ,常规治疗组 (对照组 ) 4 6例。治疗前及治疗后 1、2、3周用欧洲脑卒中量表进行神经功能评分 ,CT扫描测量水肿体积并计算水肿产生率。结果 治疗 1、2、3周后进行神经功能评分 ,试验组分值分别较治疗前增加 15 .2± 6 .8、2 0 .4± 9.4、2 6 .0± 12 .4 ,对照组分值分别较治疗前增加 10 .2± 8.4、16 .0± 10 .2、2 1.3± 11.6 ,2组比较差异有显著意义 (P <0 .0 5 )。水肿产生率试验组 (0 .32 2± 0 .0 86 )亦小于对照组 (0 .2 98± 0 .0 6 2 ) (P <0 .0 5 )。结论 脑出血急性期应用大剂量纳络酮治疗可以抑制脑水肿形成 ,提高神经功能评分 ,且效果优于常规剂量。

Objective To observe the therapeutic effects of high-dose Naloxone on cerebral hemorrhage.Methods 86 patient s with cerebral hemorrhage were randomly divided into two groups:high-dose trea tment group (n=40) and control group (n=46).Neurological function of pat ient was scored according to the European Stroke Standards of Grading for Cerebr al Apoplexy. The volume of edema was observed by CT during 10～14 days after apo plexy attack.Results After 1,2,3 weeks treatment,The neurologic al function score in the high-dose treatment group (increased 15.2±6.8,20.4±9 .4,26.0±12.4 respectively) were significantly higher than those in control grou p (increased 10.2±8.4,16.0±10.2,21.3±11.6 respectively)(P<0.05),however, the incidence of edema (0.322±0.086) was significantly lower than that of cont rol group (0.298±0.062)(P<0.05).Conclusion Naloxone can i nhibit formation of cerebral edema and enhance neurological function marks.It is suggested that high-dose Naloxone is better than routine dose one in the treat ment of cerebral hemorrhage.