盐酸纳洛酮治疗急性重症脑梗死的临床评价

Clinical Assessment of Naloxone Hydrochloride in Treatment of Acute Serious Cerebral Infarction.

目的:探讨纳络酮对急性重症脑梗死的疗效和安全性。方法:自1999年1月～2001年3月,我们对120例急性重症脑梗死的病人随机分成3组:大剂量组40例,小剂量组40例和丹参对照组40例。分别在治疗前及治疗14天后进行中国神经功能评分及格拉斯哥昏迷分级,并比较治疗前后血清β-内啡肽的变化。结果:(1)两治疗组的有效率分别为70%、62.5%,对照组的有效率为45%,差异有显著性(P<0.05)。大剂量组神经功能缺损治疗前后有显著性的差异(P<0.05)。(2)大剂量组的死亡率明显低于对照组。(3)治疗组治疗后的β-内啡肽的浓度有明显下降,较对照组有显著性的差异(P<0.01)。(4)大剂量纳洛酮对重症脑梗死所致昏迷有一定的疗效,且能早期催醒。结论:大剂量纳洛酮对重症脑梗死所致昏迷及神经功能的恢复有明显疗效,且无副作用。

Purpuse; To assessment the therapeutic effect and safety of naloxone in treatment of acute serious cerebral infarction. Methods;120 cases of acute serious cerebral infarction patients from 1999.1 to 2001.3. They were randomly divided into three groups:guoup A (large dosage) 40 cases,group B( small dosage) 40 cases and group C( radix salviae miltiorrhizae control) 40 cases. All the patients before starting the treatment and on the 14th day,evaluated were with Chinese Stroke Scale and Glasgow Index,also the β-endorphin was compared between before and after 14th day treatment Results: (1) The overall effective rate was significantly difference between group A,group B and group C,as to 70%vs 62. 5%vs 45%. There was significantly difference for Chinese Stroke Score in group A between pre-treatment and post-treatment. ( 2) There was significantly difference from death rate between group A and group C. (3) In treatment group, af-ter treatment, the serum p-endorphin concentration decreased, in comparison with the control group, there was significant difference ( P < 0.01) . (4) It was an effective method that coma could be waken early by using large dosage of naloxine in serious cerebral infarction. Conclusion:It was suggested that large dosage of naloxone was effective obviously for coma and neurological damage caused by acute serious cerebral infarction,and without side effect