纳洛酮对急性一氧化碳中毒患者血浆一氧化氮、内皮素含量的影响

Effect of Naloxone on plasma NO and ET-1 in patients with acute carbon monoxide poisoning

目的观察急性一氧化碳中毒(ACOP)患者血浆一氧化氮(NO)、内皮素(ET1)含量的变化及纳络酮对其影响。方法选择重度急性一氧化碳中毒(ACOP)患者50例,随机分为高压氧治疗组(对照组)和纳络酮+高压氧治疗组(观察组),采用硝酸还原酶法、放射免疫吸附法,分别检测两组患者治疗前后血浆NO、ET1含量的变化,并与20名健康体检者(正常组)进行对比分析。结果ACOP患者血浆NO含量较正常组显著降低,而ET1含量明显增高(P<0.01);与对照组比较纳络酮治疗后患者血浆中NO升高、ET1降低(P<0.01)。而且纳络酮治疗后患者的昏迷时间明显缩短,病死率和迟发性脑病的发生率明显减少。结论ACOP患者血中NO水平降低和ET1含量升高参与了ACOP的病理生理过程;纳络酮可提高NO水平、降低ET1含量,对NO、ET1含量的变化具有有益的调节作用,可改善ACOP的病理损害作用。

Objective To investigate the effect of Naloxone on plasma nitric oxide （NO）and endothelin-1 （ET-1）in patients with acute carbon monoxide poisoning（ACOP）. Method Fifty severe ACOP patients were randomly divided into 2 groups： control group, treated with hyperbaric oxygen;observation group treated with Naloxone and hyperbaric oxygen. NO and ET-1 in the two groups were detected before and after treament and compared with healthy persons（normal group）. The NO and ET-1 were detected by nitric acid reducing enzyme method, and radioimmunosorbont. Results The plasma NO in ACOP patients was obviously reduced compared with normal group, but ET-1 significantly increased （P 〈 0.01 ）. The plasma content of NO increased and ET-1 decreased after treating with Naloxone , compared with control group （P 〈 0.01 ）. After treated with Naloxone, the time of coma was obviously decreased. The mortality and incidence of tardive encephalopathy significantly reduced. Conclusion The plasma NO decreased and ET-1 increased in ACOP patients. Naloxone can significantly raise the level of NO and reduce ET-1 ,which is helpful in improving pathological lesion.