纳洛酮在乙型脑炎治疗中的意义

Significance of Opioid Peptide Antagonist-Naloxone in Treatment of Epidemic Encephalitis B

目的 :研究乙脑的发病与内源性阿片肽的关系 ,以及阿片肽拮抗剂纳洛酮治疗乙脑的机制和疗效。方法 :治疗组 5 6例应用纳洛酮 0 .0 2mg (kg·次 ) ,每 6～ 8h 1次 ,3～ 5d ;对照组 5 0例未用 ,余治疗相同。观察疗效 ,同时检测急性期和恢复期的血浆和CSF内源性阿片肽含量。结果 :治疗组疗效显著 ,且急性期时血浆和CSF内源性阿片肽明显高于正常值 (P <0 .0 1 ) ,至恢复期时显著下降 (P <0 .0 1 ) ,治疗组比对照组下降更明显。结论 :乙脑的发病与内源性阿片肽释放增加有关 ,纳洛酮治疗后可使内源性阿片肽下降 ,是治疗乙脑的有效药物之一。

Objective:In order to study the relationship between the pathogenesis of epidemic encephalitis B and endogenous opioid peptide as well as the clinical mechanism and the curative effect with the opioid peptide antagonist-naloxone to treat encephalitis B. Methods:106 patients were enrolled and randomly divided into naloxone group and control group. 56 patients were treated with naloxone and 50 patients didn't receive naloxone treatment. But the two group received the same therapy in other aspects. Their curative effects were observed, menawhile in acute period and convalescent stage, the contents of endogenous opioid peptide in plasma and cerebrospinal fluid (CSF) in all patients were measured by biochemical analysis. Results:The clinical curative effect of naloxone group was higher than the control group. The contents of endogenous opioid peptide in plasma and CSF in acute period were higher than normal (P<0.01) and obviously declined when entering into the convalescent stage (P<0.01), and the decline of naloxone group was more markable than that of the control group. Conclusion:There is significance correlation between the pathogenesis of encephalitis B and the increase in contents of endogenous opioid peptide. Naloxone is one of the effective medicines to treat encephalitis B since it can obviously decreases the contents of endogenous opioid peptide.