纳美芬治疗急性脊髓损伤的临床观察

Clinical assessment of nalmefene for acute spinal cord injury

目的 观察纳美芬对急性脊髓损伤患者治疗的临床特点.方法 将62例急性脊髓损伤患者完全随机分为对照组32例和纳美芬组30例.2组患者入院后,对照组仅给予常规治疗,而纳美芬组在常规治疗的基础上予以静脉注射盐酸纳美芬0.5 mg/d,连用14 d治疗.观察患者2周、3个月和6个月随访时的神经功能改善,比较二者的疗效.结果 纳美芬组和对照组的运动功能评分在治疗后2周分别为11.6±4.6 和8.4±3.6,3个月后分别为19.0±5.7和15.3±4.7,6个月后分别为25.7±5.5和21.9±4.9,2组差异均有统计学意义（P〈0.05或P〈0.01）;2组的痛觉评分在治疗后2周分别为8.1±3.0和6.6±3.2,3个月后分别为14.3±3.9和9.6±3.6,6个月后分别为16.3±3.8和11.7±3.9,2组差异均有统计学意义（均P〈0.05）;2组的触觉评分在治疗后2周分别为6.7±2.8和4.8±2.4,3个月后分别为9.1±2.7和7.8±2.3,6个月后分别为11.2±3.2和9.2±2.6,2组差异均有统计学意义（均P〈0.05）.结论 纳美芬能够促进急性脊髓损伤患者的神经功能恢复,改善患者预后.

Objective To investigate the effects of nalmefene on acute traumatic spinal cord injury. Methods Sixty-two patients of acute traumatic spinal cord injury were randomly divided into two groups. One group contained subjects treated with nalmefene, and the other contained control group subjects. The control group included 32 patients whom received conventional therapy, while the 30 patients in the nalmefene group were injected with 0.5 mg/d nalmefene for 14 days in addition to receiving the conventional therapy. Subsequently, the subjects underwent a neurological evaluation, with the American spinal injury association （ASIA） assessing and comparing the results, including analysis of motor and sensory function at 2 weeks, 3 and 6 months after treatment. Results The recovery scores between Nalmefene-treated group and control group in motor function were 11.6±4.6 and 8.4±3.6 （P〈0.05） at 2 weeks, 19.0±5.7 and 15.3±4.7 （P〈0.01） at 3 months, 25.7±5.5 and 21.9±4.9 （P〈0.01） at 6 months, respectively. The recovery scores between 2 groups in pain sensory function were 8.1±3.0 and 6.6±3.2 （P〈0.05） at 2 weeks, 14.3±3.9 and 9.6±3.6 （P〈0.01） at 3 months, 16.3±3.8 and 11.7±3.9 （P〈0.01） at 6 months, respectively. Additionally, recovery score between 2 groups in touch sensory function were 6.7±2.8 and 4.8±2.4 （P〈0.05） at 2 weeks, 9.1±2.7 and 7.8±2.3 （P〈0.05） at 3 months, 11.2±3.2 and 9.2±2.6 （P〈0.05） at 6 months, respectively. Compared with control group, the nalmefene-treated group showed significantly greater recovery in both motor and sensory functions at 2 weeks, 3 and 6 months after treatment. Conclusion Nalmefene can promote neurological functional recovery in patients with acute spinal cord injury and improve their prognosis.