纳洛酮对急性缺血性脑卒中患者血清血管内皮细胞生长因子和碱性成纤维细胞生长因子表达的影响

Effects of naloxone on vascular endothelial growth factor and basic fibroblast growth factor in patients with acute ischemic stroke

目的观察纳洛酮对急性缺血性脑卒中患者血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)表达的影响。方法将160例急性缺血性脑卒中患者随机分为对照组和纳洛酮组各80例。对照组给予改善循环、营养神经、抗血小板聚集及调脂等治疗;纳洛酮组在对照组治疗基础上加用纳洛酮2.4mg+0.9%NaCl 250mL静脉滴注,1次/d,连续应用14d。均于治疗前和治疗后14d抽取卧位静脉血,采用酶联免疫吸附测定法检测血清中VEGF、bFGF的水平;均在入院治疗前和治疗后14d采用美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)进行神经功能缺损评分。结果纳洛酮组神经功能缺损改善程度明显优于对照组(P<0.01);治疗后14d2组NIHSS评分均有下降,但纳洛酮组NIHSS评分明显低于对照组(P<0.01);治疗后14d2组VEGF水平均增加,但纳洛酮组明显高于对照组(P<0.01);治疗后14d对照组bFGF的水平较治疗前无明显变化(P>0.05),但纳洛酮组bFGF水平明显增加(P<0.01);NIHSS评分与VEGF、bFGF表达呈负相关,即VEGF、bFGF表达水平越高,NIHSS分值越低。结论纳洛酮可以通过显著增加脑梗死患者血清中VEGF、bFGF表达水平改善神经功能缺损程度。

Objective To observe the effects of naloxone on vascular endothelial growth factor（VEGF）and basic fibroblast growth factor（bFGF）in patients with acute ischemic stroke.Methods One hundred and sixty patients with acute ischemic stroke were randomly divided into control group and naloxone group,80 cases each group.The control group received treatment in improving circulation,nerve nutrition,anti-platelet aggregation and lipid-lowering drug therapy;on the basis of control group,naloxone group got treated with naloxone 2.4mg＋0.9% NaCl 250 mL intravenous drip once a day,continuous application for 14 days.Before and after treatment 14 days,both groups were extracted decubitus venous blood,then the serum VEGF and bFGF were determined with enzyme-linked immunosorbent assay.Before and after treatment 14 days,the neural function defect scale was scored by the US National Institutes of Health Stroke Scale（NIHSS）.Results The degree of neurological deficit in naloxone group improved significantly better than that of control group（P〈0.01）;after treatment 14 days,the NIHSS score of both groups declined,but naloxone group was significantly lower than control group（P〈0.01）;after treatment 14 days,VEGF in both groups increased,but naloxone group was significantly higher than control group（P〈0.01）,after treatment 14 days,bFGF in control group showed no significant change after treatment（P〈0.05）,while naloxone group showed increase significantly（P〈0.01）;NIHSS scores had negative correlation with VEGF,bFGF levels,namely the NIHSS score was lower when VEGF and bFGF were higher.Conclusion Naloxone significantly increases VEGF and bFGF level in patients with cerebral infarction so as to improve the degree of neurological deficit.