不同剂量纳洛酮对重型颅脑损伤后β-内啡肽影响的实验研究

Effect of Different Doses of Naloxone on the Changes of β-endorphin(B-EP) in Patients with Traumatic Brain Injury

目的观察重型颅脑损伤患者不同剂量纳洛酮对血浆β-内啡肽变化的影响。方法对重型颅脑损伤后的124例患者随机分为对照组(n=40)和小剂量治疗组A(n=40)及大剂量治疗组B(n=44)。均在常规治疗的基础上,分别以不同剂量给予纳洛酮治疗,动态监测患者血浆β-内啡肽(β-EP)的变化。结果治疗第3 d及第7 d,A组及B组患者血浆β-EP含量少于对照组,差异有统计学意义(P<0.01),B组患者治疗血浆β-EP含量少于A组,差异有统计学意义(P<0.05)。结论早期、大剂量纳洛酮治疗能更有效地提高弥漫性轴索损伤患者的临床疗效,促进神经功能恢复。

Objective To observe the effect of different doses of naloxone on the plasma level of β-endorphin（B-EP） in traumatic brain injury（TBI） patients. Methods Altogether 124 patients with TBI were randomly divided into control group（n=40）,small-dose naloxone group（group A,0.1 mg/kg·d,n=40） and large-dose naloxone group（group B,0.4 mg/kg·d,n=44）.On the basis of routine measures,different doses of naloxone were administered intravenously in treatment of patients with TBI.The plasma level of B-EP was dynamically monitored. Results On the 3rd and 7th days of the treatment,the plasma level of β-EP was lower in group A and group B than that of control group,and the difference was statistically significant（P〈0.01）.The plasma level of β-EP was lower in group B than in group A,and there were statistically significant differences between the two groups（P〈0.05）. Conclusions The curative effect of the patients with diffuse axonal injury can be further improved by early intravenous injection of large-dose naloxone.