纳洛酮对急性颅脑损伤患者血浆内皮素、降钙素基因相关肽和氧自由基含量的影响

Effect of naloxone on the contents of endothelin calcitonin gene-related pepitide and oxygen free radical in the patients with acute cerebral injury

目的 探讨纳洛酮对急性颅脑损伤 (ACI)患者开颅手术后血浆内皮素 (ET)、降钙素基因相关肽 (CGRP)和氧自由基 (OFR)含量的影响。方法 以放射免疫分析方法测定 40例ACI患者手术前后血浆ET、CGRP含量 ,用电子自旋共振 (ESR)方法测定血浆OFR浓度 ,并以 40例健康献血者为术前对照。结果 ACI患者术前血浆ET、OFR明显高于正常对照组 (均P <0 0 1) ;开颅手术后 12 0min两组ET、OFR较术前有显著性升高 (均P <0 0 1) ,CGRP显著性降低 (P <0 0 5 )。A组给予纳洛酮 2 0μg/kg静脉注射后 30min ,血浆ET、OFR均较治疗前显著性降低 (均P <0 0 1) ,而CGRP较治疗前呈显著性升高 (P <0 0 1) ,与B组组间比较有显著性差异 (均P <0 0 1)。结论 临床治疗剂量的纳洛酮可明显提高ACI患者体内CGRP水平 ,降低ET 。

Objective To study the effect of naloxone on the plasma contents of endothelin (ET) calcitonin gene-related pepitide (CGRP) and oxygen free radical (OFR) in patients with acute cerebral injury (ACI) during neurosurgery. Methods Plasma ET, CGRP were determined by radioimmunoassay method and OFR were by electron spin resonance (ESR) specotroscopy method.Results ET and OFR were significantly increased before anesthesia in patients with ACI compared to normal value (all P <0.01).CGRP level was significantly lower in patients with CHF compared to normal value (all P <0.01). At 120 minutes after neurosurgery ET and OFR were significantly increased (all P <0.01).Meanwhile, CGRP level was significantly decreased ( P <0.05).After treatment with naloxone, the CGRP level was significantly increased ( P <0.01) and ET, OFR were significantly decreased (all P <0.01). Conclusion Therapeutic dose of naloxone may markedly increasing the level of CGRP in vivo and also antagonistic effect on the content of ET. Naloxone may play a role in brain protection and act as an OFR scavenger in vivo. [