盐酸纳洛酮对颅脑手术病人血浆和脑脊液β-内啡肽的影响

目的:通过观察在颅脑手术中盐酸纳洛酮对血浆和脑脊液中β-内啡肽(β-EP)的影响,探讨盐酸纳洛酮的脑保护作用.方法:32例择期颅脑手术病人ASAⅠ～Ⅱ级,随机分为纳洛酮组(Ⅰ组)和对照组(Ⅱ组).采用放射免疫分析法检测血浆及脑脊液中β-EP的含量.结果:纳洛酮组在给药后1 h( T2期)、给药后2 h(T3期)和给药后3 h(T4期)血浆β-EP含量分别为(187.76±81.37)、(109.56±45.92)和(69.37±21.66) ng*L-1,脑脊液中含量分别为(2 169.61±416.37)、(1 369.85±433.55)和(987.62±278.19) ng*L-1,均较给药前(T1期)即开始切硬膜时低(P<0.05),纳洛酮组血浆和脑脊液中的β-EP均低于对照组同期值(P<0.05).结论:颅脑手术围术期应用纳洛酮可以使脑脊液和血浆中β-EP含量降低,从而说明应用纳洛酮可以减轻脑水肿和损伤,保护脑细胞.

Effect of hydrochloride naloxone on β-endorphin in plasma and cerebrospinal fluid during craniotomy

Objective:To observe the effect of hydrochloride naloxone on β endorphin in plasma and cerebrospinal fluid (CSF),β EP, during craniotomy. Methods:Thirty two patients (ASA 1~2) receiving the neurosurgery were divided randomly into hydrochloride naloxone group (Ⅰ) and control group (Ⅱ). Measure β EP in plasam and CSF using the radio immanoassay (RIA) while MAP, Tp and HR were monitored. Results:After applying hydrochloride naloxone 1 hour (T 2) , 2 hours (T 3) and 3 hours (T 4) β EP was (ng·L -1 ), plasam:187 76±81 37, 109 56 ±45 92, 74 76±38 90,respectively, and 2169 61±416 37,1369 85±433 55, 987 62±278 19 in CSF, respectivel. In comparission with T 1 in both specimens level of β EP was signifcantly decreased than those of control group ( P <0 05). Conclusion:application of hydrochloride naloxone could decrease β EP in plasam and CSF and protect cerebral cells during craniotomy.