摘要
目的:探讨不同剂量纳络酮治疗脑出血对其神经功能保护作用的量效关系.方法:脑出血患者120例,随机分为纳络酮高(H)、中(M)、低(L)剂量治疗组,每组40例,分期测患者血肿体积和水肿带面积、血清神经元特异性烯醇化酶(NSE)水平,进行神经缺损及ADL评定.结果:资料完整患者H组32例、M组29例、L组34例.①3组组内血肿体积和水肿带面积随时间变化有差异(P<0.001);组间比10d时血肿体积L组明显>M组>H组(P<0.001),水肿带面积L组>M组>H组(P<0.002),但20d组间血肿体积及水肿带面积均无差异;②出血后12h内患者血清NSE升高,20d时明显下降且组间比NSE值有差异(P<0.001),明显H组<M组<L组;③神经功能评分20d时值明显H组<M组<L组(P<0.02);3mo后ADL评分H组>M组>L组(P<0.001).结论:0.3mg/(kg·d)纳络酮治疗具有更良好的保护患者神经元、降低功能缺损、提高预后生活质量的作用.
AIM ： To explore the dose-effect relationship of neuron-protective effect of different doses of naloxone in patients with intracerebral hemorrhage. METHODS： One hundred and twenty patients were randomly divided into 3 groups of 40 cases each： high dose （H）, medium dose （M） and low dose （L） groups. The hematoma volume and edema-zone areas, the level of neuron specific enolase （NSE） in serum, nerve-function-defect score and the ADL score were examined at particular time respectively. RESULTS： ① There were significant differences in the hematoma volume and edema-zone area at different times points within a group （ P 〈 0.001 ）. However, among different groups, the hematoma volume of L group was larger than those of H and M groups at 10 d （P〈0.00]） and the edema-zone area of L group was larger than that of M and H groups（P〈 0.002）. But at 20 d, there was no significant difference in the hematoma volume and edema-zone area among the 3 groups. ② There was an increase of NSE in serum at 12 h after hemorrhage in all the patients. Moreover, NSE significantly decreased at 20 d and there were significant differences among the groups. The level of NSE in H group was lower than that in M group and that in M group was lower than that in L group（ P 〈 0.001 ）. ③ The nervefunction-defect scores of H group was higher than those of M group and L group at 20 d（ P 〈 0.02）. The ADL scores of H group was higher than that of M group and the score of M group was higher than that of L group at 3 mo（ P〈0.00] ）. CONCLUSION： Therapy with naloxone of 0.3 mg/（kg · d） each day can protect neurons, decrease the function defect and improve living conditions in patients with intracerebral hemorrhage.
出处
《第四军医大学学报》
北大核心
2005年第18期1713-1715,共3页
Journal of the Fourth Military Medical University
关键词
脑出血
纳络酮
剂量-效应关系
药物
磷酸丙酮酸水合酶
cerebral hemorrhage
Naloxone
dose-re-sponse relationship, drug
phosphopyruvatehydratase
