纳洛酮对新生儿呼吸窘迫综合征后氧化应激的影响及心肌损害的保护作用

目的探讨纳洛酮对新生儿呼吸窘迫综合征(NRDS)的心肌保护作用及氧化应激的影响。方法选择NRDS患儿86例,按数字表法随机分为对照组43例和治疗组43例;两组均给予呼吸机机械通气;对照组给予盐酸氨溴索注射液,每日30 mg/kg,分4次静滴,连用3 d;治疗组在对照组基础上给予盐酸纳洛酮注射液,每次0.05 mg/kg,连用3 d。比较两组血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(c Tn I)及氧分压(Pa O2)和二氧化碳分压(Pa CO2)水平;检测两组血清总超氧化物歧化酶(SOD)、丙二醛(MDA)和还原型谷胱甘肽(GSH)含量。结果治疗后,治疗组血清CK(382.51±39.72)U·m L-1、CK-MB(71.55±7.57)U·m L-1和c Tn I(325.17±33.96)pg·m L-1水平及Pa CO2(40.67±4.77)mm Hg显著低于对照组,而Pa O2(80.25±8.93)mm Hg明显高于对照组(72.76±7.82)mm Hg(P0.01);治疗后,治疗组血清中SOD(86.93±9.05)μU·L-1和GSH(112.64±12.16)ng·m L-1含量均显著高于对照组SOD(70.31±7.49)μU·L-1和GSH(98.39±9.90)ng·m L-1,MDA(4.53±0.51)/μmol·L-1含量明显低于对照组(5.82±0.63)μmol·L-1,比较差异有统计学意义(P0.01)。结论在常规治疗基础上纳洛酮对NRDS心肌保护疗效明显,抑制氧化应激反应可能是其作用机制之一。

Effect of naloxone in the treatment of neonatal respiratory distress syndrome with oxidative stress and protec-tion on myocardial damage

Objective To investigate the protection of naloxone for myocardial damage of neonatal respiratory distress syndrome(NRDS)and the influence on oxidative stress.Methods 86 NRDS were randomly divided into the control group (43 cases)and the treatment group (43 cases).All patients were treated with mechanical ventilation by breathing machine.The control group was given ambroxol hydrochloride injection for 3 days (30mg/kg/d,q6h), and the treatment group was additionally treated with naloxone hydrochloride injection for 3 days (0.05mg/kg/time). Their serum levels of creatine kinase (CK),creatine kinase-MB (CK-MB),troponin (cTnI),partial pressure of ox-ygen (PaO2 ),and carbon dioxide (PaCO2 )were compared between the two groups.The serum levels of total super-oxide disumutase (SOD),malondialdehyde (MDA),and reduced glutathione (GSH)were detected in the two groups.Results The serum level of CK was 382.51 ±39.72 U·mL -1 ,CK-MB was 71.55 ±7.57 U·mL -1 ,cTnI was 325.17 ±33.96 pg·mL -1 ,and PaCO2 was 40.67 ±4.77 mmHg in the treatment group,which were obviously lower than thoase in the control group.While the level of PaO2 was 80.25 ±8.93 mmHg in the treatment group, which was evidently higher than that in the control group (P <0.01 ).After treatment,the serum levels of SOD (86.93 ±9.05)μU·L -1 and GSH (112.64 ±12.16)ng·mL -1 in the treatment group were obviously higher than those in the control group,while MDA (4.53 ±0.51)μmol·L -1 was evidently lower than that in the control group (5.82 ±0.63)μmol·L -1 (P <0.01).Conclusion Based on conventional treatment,naloxone can protect myo-cardial damage in treating NRDS,and the mechanism may be oxidative stress inhibition.