纳洛酮对急性重症非心源性脑梗死患者血浆BNP水平的影响

摘要

目的 观察纳洛酮对急性重症非心源性脑梗死患者血浆BNP的影响,探讨其脑保护作用机制.方法 将116例重症非心源性脑梗死患者(NIHSS≥8,GCS≤8 分)随机分为治疗组(n=58)和对照组(n=58),对照组入院后给予常规治疗,治疗组在常规治疗的基础上给予盐酸纳洛酮静脉注射,分别于入院1、3、7 d检测血浆BNP水平,同时进行NIHSS、GCS评分,根据脑水肿CT值判断脑水肿程度.结果 2组3 d、7 d时血浆BNP水平均明显增高,脑水肿较重,神经功能缺损严重,与对照组相比,治疗组血浆BNP水平下降,脑水肿、神经功能缺损程度均减轻(P<0.05).结论 纳洛酮可显著改善急性重症非心源性脑梗死神经功能缺损程度,减轻脑水肿,其神经保护作用可能与下调血浆BNP水平有关.%Objective To observe the effect of naloxone on plasma BNP level in patients with severe acute non-cardiogenic cerebral infarction (ANCCI) and to explore its protective mechanism.Methods We collected 116 cases with severe ANCCI (NIHSS≥8 scores,GCS ≤8 scores) in our study and randomly divided all cases into treatment group (n=58) and control group (n=58).Routine therapy was given for control group and combination of naloxone injection with routine therapy was given for treatment group.Plasma BNP level was detected on the 1st,3rd and 7th days and NIHSS and GCS were used to evaluate neurological function.Based on CT value we estimate the degree of brain edema.Results On the 3rd and 7th days the two groups showed high levels of plasma BNP,severe brain edema and serious neurological functional deficits.Compared with control group,treatment group presented lower level of BNP and less injury of brain edema and neurological function (P<0.05).Conclusion Naloxone can effectively improve the degree of neurological functional deficits and relieve brain edema.Its neuroprotective effect may be associated with down-regulation of plasma BNP level.