纳络酮对重型脑损伤患者脑脊液中IL-6含量及预后的影响

目的研究纳络酮对急性重型颅脑损伤（sTBI）患者脑脊液中白细胞介素-6（IL-6）含量及预后的影响。方法按患者入院序号将68例sTBI患者平均分为纳络酮治疗组与对照组,采用放射免疫法检测纳络酮治疗前、后不同时段脑脊液中IL-6含量变化,同时对两组患者GCS、颅内压（ICP）及预后进行比较观察。结果sTBI患者早期脑脊液中IL-6含量明显增高。与对照组相比,纳络酮治疗后1d,治疗组病人ICP值与IL-6含量明显降低（P〈0.05）;3d后IL-6含量达到最低水平,直到治疗后21d仍明显低于对照组（P〈0.01）。在纳络酮治疗后3d和7d患者意识障碍较对照组改善明显（P〈0.05）。伤后6个月治疗组恢复较好者的百分率明显高于对照组（P〈0.01）。结论sTBI患者急性期脑脊液中IL-6含量增高,纳络酮可以降低ICP和抑制IL-6超表达,改善sTBI患者的临床预后。

Effect of Naloxone on Change in CSF IL-6 Concentration and Prognoses in Patients with Acute Severe Traumatic Brain Injury

Objective To investigate the effects of naloxone on interleukin-6（IL-6） concentration in the cerebrospinal fluid（CSF） and the prognoses in the patients with acute severe traumatic brain injury（sTBI）. Methods Sixty-eight patients with sTBI were randomly divided into both the treatment and control groups of 34 patients each. CSF IL-6 concentration, intracranial pressure（ICP） and GCS were determined in all the patients before the trestment and at different time after the treatment. The prognoses were compared between both the groups. Results The CSF IL-6 levels were significantly lower in the treatment group than those in the control group 1, 3, 7 days and 21 days after the treatment （P〈0.05）. ICP was significantly lower in the treatment group than that in the control group 1, 3 and 7 days after the treatment （P〈0.05）. GCS was significantly higher in the treatment group than that in the control group 3 arid 7 days after the treatment （P〈0.05）. The percentage of the patients with good prognosis was significantly higher in the treatment group than that in the control group （P〈0.01）. Conclusion Naloxone can significantly decrease the level of the increased ICP, inhibit the overexpression of IL-6, and improve prognosis in patients with acute sTBL.