纳洛酮对重型脑损伤患者血浆内皮素水平的影响

Effect of the nalxolone on the ET level in the plasma of severe head-injured patients

目的 观察纳洛酮对重型脑损伤患者的疗效及对血浆内皮素 (ET)含量影响。方法 对入选的 116例伤后 12h入院重型脑损伤 (GCS <8分 )患者 ,在常规综合治疗基础上随机分为 2组 ,纳洛酮治疗组 5 9例 ,每天 8mg纳洛酮持续微量泵静推。以 5 7例同等伤情未用纳酮洛治疗病例为对照组 ,于治疗后 2 4h、5d、10d采用特异性放射免疫分析法测定血浆中ET含量 ,观察GCS评分并与对照组进行比较。结果 伤后 12h两组患者血浆ET含量均较正常值明显增高 ,治疗后两组患者血浆ET水平均下降 ,于第 5d、10d治疗组ET值明显低于对照组 (P <0 .0 5 ) ;10d后治疗组GCS评分明显提高 (P <0 .0 5 ) ;治疗组病死率明显低于对照组 (P <0 .0 5 )。结论 伤后早期应用大剂量纳洛酮可以明显降低重型颅脑伤患者血浆ET水平 。

Objective:To observe the curative effect and the ET level in the plasma with the nalxolone,which was used to the severe head-injured patientsMethods:12 hours after injured accident,116 cases of severe cerebral injury patients were devided into 2 groups randomly ,who all were cared with General therapy.59 cases belonged to the control group ,Who were therapied with 8 mg nalxolone every day ,and the last belonged to the contrast group.24 hours,five days and 10 days after the care ,the ET in plasma were examined with differential radiation-immunology technical.At the same time ,the GCS was used to grade the trauma condition.The results of the both Groups were compared with each other.Results:It was observed that the ET level in plasma descended in bot groups during the care progress.It was definitely lower in the control group than the contrast group at the 5th day and the 10 days after care and the GCS grade of the controlled group was higer than the one of the contrast group 10th day after thecare.Conclusions:The ET level in plasma of severe head injured patients could be lowered with Alage dose of nalcolone used early.The aftermath of severe head injured could be improved.