纳洛酮对重度急性有机磷农药中毒脑损害的干预作用

The brain protection of Naloxoneon patients with acute organ phosphorus pesticide poisoning.

目的目的研究纳洛酮对重度急性有机磷农药中毒（AOPP）患者脑保护作用及其可能机制。方法对106例重度急性有机磷农药中毒患者随机分为纳洛酮治疗组（54例）和常规治疗组（52例），2组基础治疗相同，纳洛酮治疗组在传统综合抢救基础上给予纳洛酮0．8mg静脉注射，每20分钟1次，直至患者症状缓解或清醒；观察2组病死率以及临床症状，并于治疗前及治疗后2h测血浆β-内啡呔含量（B-EP）及丙二醛（MDA）浓度。另设正常对照组（50例）。结果纳洛酮治疗组与常规治疗组意识转清时间分别为（16．71±3．17）h与（20．84士3．25）h，2组差异有统计学意义（P〈0．05）。纳洛酮治疗组病死率9．26％（5／54）低于常规治疗组病死率28．85％（15／52）（P〈0．01）。纳洛酮治疗组治疗后B-EP呔含量（673．76±179．25）ng／L较治疗前（815．88±192．94）ng／L明显降低（P〈0．05）；MDA含量治疗后（12．74±4．48）nmol／ml较治疗前（27．19±4．33）nmol／ml明显降低（P〈0．05），常规治疗组治疗前后变化不明显。结论纳洛酮能减少重度有机磷患者清醒时间，具有抗氧化自由基作用，对急性有机磷农药中毒患者脑损害具有保护作用。

Objective To study the therapeutic effect and significance of Naloxone on the brain function in patients with acute organ phosphorus pesticide poisoning. Methods 106 patients with acute organ phosphorus pesticide poisoning were randomly allocated to two groups according to the hospitalized date, the NX group（n = 54） and the normal group（ n = 52 ）. The two groups received the same basic treatment and the dynamic monitor about the changes of the β-EP and MDA levels in each groups, and the NX group was given additional treatment with 0.8 mg Naloxone-intravenous injection every 20 minutes till consciousness recovering or symptoms improved. Results The time of recovering consciousness was （ 16.71 ± 3.17 ） h in NX group and （20.84 ±3.25 ） h in control group. β-EP and MDA were higher than normal before treatment in all patients （P 〈 0.01 ）, and were significantly reduced after treatment in NX group （P 〈 0.05）, the control group had mild change after treatment. Conclusion Relating to the inhibition of oxygen free radicals, Naloxone can reduce time of recovering consciousness and can protect the injured brain of the patients with acute organ phosphorus pesticide poisoning.