纳美芬对急性重症颅脑损伤患者血清β-EP和NSE水平的影响

Effects of nalmefene on levels of β-EP and NSE of patients with acute severe traumatic brain injury

目的观察探讨纳美芬对急性重症颅脑损伤患者血清β-内啡肽和神经元特异性烯醇化酶的影响。方法选取我院治疗的110例急性重症颅脑损伤患者,随机分为两组。对照组采取降低颅内压、抗感染、预防癫痫等常规治疗,观察组在常规治疗的基础上,加用盐酸纳美芬治疗。检测治疗前后患者血清β-内啡肽(β-EP)、神经元特异性烯醇化酶(NSE)水平变化,观察记录治疗期间患者呼吸、心跳异常发生情况;治疗3个月后,对患者预后采用格拉斯哥评分进行评价。结果治疗1 w后,观察组血清β-EP和NSE水平均显著降低(P<0.05),而对照组却反而升高,并显著高于治疗前水平(P<0.05)。治疗中,观察组呼吸、心跳异常的发生率低于对照组(P<0.05);治疗3个月后,观察组格拉斯哥预后评分明显高于对照组(P<0.05)。结论纳美芬对急性重症颅脑损伤患者临床疗效显著,可有效降低患者血清β-EP和NSE含量,恢复患者异常心跳及呼吸节律,改善患者的预后,且治疗安全性好。

Objective To observe the effects of nalmefene on the levels of β-EP and neuronspecific enolase （NSE） of patients with acute severe traumatic brain injury. Methods A total of 110 patients with acute severe traumatic brain injury admitted to our hospital were selected and randomly divided into two groups. The control group was treated with such conventional therapies as reduction of intracranial pressure, anti-infection and prevention of epilepsy; on this basis, the observation group was additionally treated with nalmefene hydrochloride. The changes in the levels of β-EP and NSE of patients before and after the treatment were detected, with the incidence of abnormal breathing and heartbeat recorded; GCS was applied to the evaluation of the patients＇ prognosis three months after the treatment. Results One week after the treatment, the levels of β-EP and NSE in the observation group decreased significantly （P 〈 0.05）, while those in the control group increased and were much higher than those before the treatment （P 〈 0.05）. During the treatment, the incidence of the abnormal breathing and heartbeat in the observation group was lower than that in the control group （P 〈 0.05）; three months after the treatment, the GCS in the observation group was apparently higher than that in the control group（P 〈 0.05）. Conclusion Nalmefene is effective in the treatment of acute severe traumatic brain injury and can lower the levels of β-EP and NSE, restore abnormal heart rate and respiratory rhythm and improve the patients＇ prognosis and has high therapeutic safety.