纳洛酮对大脑中动脉区梗死躯体感觉诱发电位的影响

Naloxone's effect on somatosensory evoked potentials of middle cerebral artery territory infarction

目的 :应用躯体感觉诱发电位 (SEP)的脑功能评价法观察纳洛酮对脑梗死即刻效应。方法 :68例急性大脑中动脉区梗死病人 ,分为内囊组 (n =17)、放射冠组 (n =2 9)和皮质组 (n =2 2 ) ,给予纳洛酮 0 .8mg ,im ,st,分析纳洛酮治疗前后的SEP表现 ,观察指标为N2 0 波幅。结果 :纳洛酮治疗前后N2 0 波幅 ,在内囊组分别为 76± 19和 112± 33,P <0 .0 1,在放射冠组分别为 70± 2 0和 4 9± 17,P <0 .0 1,在皮质组分别为 5 3± 2 1和 74± 2 4 ,P <0 .0 1;各组临床表现、梗死灶大小与治疗前N2 0 波幅相关。结论 :纳洛酮短时间内提高了内囊梗死和皮质梗死的大脑皮层兴奋性 ,降低了放射冠梗死的大脑皮层兴奋性。

AIM: To evaluate the instant effect of naloxone for brain infarction with somatosensory evoked potentials (SEP). METHODS: Sixty eight patients of acute middle cerebral artery (MCA) infarction were divided into three groups: internal capsule group 17 patients; corona radiata group 29 patients; cortex group 22 patients. Naloxone 0.8 mg was administered im, st. Then the different amplitudes of N 20 of SEP before and after treatment were analysed. RESULTS:In the internal capsule group and cortex group, the N 2O amplitudes elevated significantly (76±19 vs 112±33, P <0.01); in the corona radiata group, N 20 amplitude lowered significantly (70±20 vs 49±17, P <0.01). The N 20 amplitude correlated with the clinical manifestations and infarction size of different group. CONCLUSION: In short time, naloxone can increase the cortical excitability of internal capsule and cortical infarction patients; and decrease the cortical excitability of corona radiata infarction patients.