金尔伦(盐酸纳洛酮)治疗急性中、重型脑外伤的神经电生理研究

Neuroelectrophysiological study on effect of Naloxone on acute moderate and severe head injuries

目的 通过诱发电位 (EP)监测 ,探讨金尔伦 (盐酸纳洛酮 )治疗急性中、重型脑外伤的疗效。方法 对 40例急性中、重型脑外伤患者进行随机、双盲治疗。前 3天剂量为每日 0 3mg/kg ,后 7天剂量为 4 8mg/日 ,于用药前、用药后 30分钟、 2 4小时、 72小时、 12 0小时监测正中神经短潜伏期体感诱发电位 (SLSEP)和脑干听觉诱发电位 (BAEP)。揭盲后分为金尔伦治疗组和对照组 ,对金尔伦治疗组与对照组诱发电位进行统计学分析。结果 金尔伦治疗组SLSEP的N13 N2 0峰间潜伏期(N13 N2 0IPL)及BAEP的I V波峰间潜伏期 (I VIPL)在用药后均较对照组缩短且有显著性差异 ,P <0 0 5。结论 诱发电位监测结果表明 :金尔伦能有效改善急性脑外伤患者异常的神经电生理指标 ,对于急性中、重型脑外伤有明显的治疗作用。

Objective To evaluate the effect of naloxone with evoked potential(EP) on acute head injuries. Methods A double blind clinical trial of naloxone in which 40 patients with moderate and severe head injuries were treated with either naloxone or normal saline for ten days was undertaken. The patients fallen randomly into the naloxone treating group were given intravenously 0 3mg.kg 1 d 1 naloxone hydrochloride for the first three days and 4 8mg.d 1 naloxone hydrochloride for the following seven days. Median nerve short latency somatosensory evoked potentials (SLSEP) and brain stem auditory evoked potentials(BAEP) were recorded before and 30 minutes, 24, 72 and 120 hours after the administration. The changes of EP were analyzed statistically. Results N13 N20 interpeak latency (IPL) in SLSEP and I V IPL in BAEP after administration of naloxone were reduced significantly and different statistically from those of the control group (P<0 05). Conclusions These results indicate that naloxone is beneficial in the treatment of moderate and severe head injuries in terms of improved neuroelectrophsiology.