纳洛酮对急性脑血管病患者意识障碍的作用

The Clinical Effect of Naloxone on Disturbance of Consciousness in the Patients with Acute Cerebrovascular Disease

目的 :探讨急性脑血管病意识障碍患者血浆 β 内啡肽 (β EP)含量的改变及纳洛酮的治疗作用。方法 :格拉斯哥 庇斯布赫昏迷分度表 (Glasgow Pittsburghcomascale ,G Pcs)评分≤ 2 0分的 4 5例急性脑血管病意识障碍患者随机分为对照组 (予常规治疗 )和治疗组 (在对照组治疗的基础上 ,予纳洛酮 1 6mg加入 0 9%NS 10 0mL ,静滴 ,bid ,疗程 10天 ) ;用放射免疫法检测不同时间血浆 β EP的水平 ,用G Pcs评定疗效。结果 :治疗组治疗后 3天、 10天血浆中 β EP水平明显低于治疗前 (P <0 0 1) ,与对照组比较有统计学意义 (P <0 0 1)。治疗组在各个时点上G Pcs平均分数均高于对照组 (P <0 0 1或P <0 0 5 )。结论 :纳洛酮对急性脑血管病意识障碍有催醒作用 ,其机制与拮抗 β

Objective:To observe the changes of β endorphin(β EP) in plasma an d the clinical effect of Naloxone on disturbance of consciousness in the patient s with acute cerebrovascular disease. Methods:The Glasgow Pittsburgh coma scale (G Pcs) was used to record. Forty five patients with disturbance of consciousness of acute cerebrovascular disease(≤20 scores)were random ly divided into control group (given routine medication)and treatment group [given routine medication and 1 6mg of Naloxone in normal saline of 100mL(0 9%),iv,drip,bid].The course of treatment lasted 10days . The contents of β EP in plasma before and after treatment were determined and the clinical effect was evaluated by G Pcs at the same time. Results:At treatm ent group,the contents of β EP in day 3 and day 10 after treatments were lower than before(P<0 01).The average scores with G Pcs in treatment group were higher than those in control group(P<0 01 or P<0 05). Conclusion:Naloxone produces awakening effect on coma in acute cerebrovas cular disease.The mechanism is related to its contradicting β EP activity.