盐酸纳美芬对急性颅脑损伤患者脑保护作用的临床研究

发布时间：2018-04-17 15:50

本文选题：盐酸纳美芬 + 颅脑损伤　；参考：《中南大学》2013年硕士论文

【摘要】：目的：研究急性颅脑外伤患者应用盐酸纳美芬后血清p-内啡肽(p-EP)、强啡肽(DynA1-13)、神经元特异性烯醇化酶(NSE)的变化,评价盐酸纳美芬对急性颅脑损伤患者的脑保护作用及不良反应。方法：选取急性颅脑损伤患者40例,并随机分为盐酸纳美芬治疗组和对照组各20例。治疗组在降颅压、抗感染、预防癫痫、营养支持等常规治疗的基础上加用盐酸纳美芬0.2mg/次,每天2次静脉滴入,连续应用10天；对照组按照常规治疗与治疗组相同,不加用盐酸纳美芬治疗。所有患者在治疗前以及治疗后第1、2、3、5、7、10天测定血清β-EP、DynA1-3、NSE的含量,同时记录患者的心率、呼吸频率变化及药物不良反应。结果：治疗组的血清p-EP、DynA1-13、NSE的含量明显低于对照组,其总体变化趋势是下降,到治疗第10天时以上指标的下降幅度分别为32.44%、36.91%、46%。对照组的β-EP、DynA1-13的总体变化趋势是升高,到治疗第10天时p-EP、DynA1-13的升高幅度分别为11.73%、12.21%,对照组的NSE总体变化趋势是下降,到治疗第10天时下降幅度为25.45%。以上三个指标在治疗组与对照组中均有显著差异。治疗组的呼吸异常率及心率异常率均低于对照组,差异显著。两组治疗过程中出现的药物不良反应患者例数未发现有显著差异。结论：盐酸纳美芬可降低急性颅脑损伤后患者血清β-EP、DyIA1-13、NSE的含量,能减轻急性颅脑损伤患者的继发性病理损伤,有一定的脑保护作用,并可改善急性颅脑损伤患者的心率异常率和呼吸异常率。应用盐酸纳美芬后未加重和出现新的不良反应。图6幅；表13个；参考文献58篇。
[Abstract]:Objective: to study the changes of serum pendorphin p-EPN, dynorphin dyna 1-13, neuron-specific enolase (NSE) in patients with acute craniocerebral trauma after the application of namefen hydrochloride, and to evaluate the protective effect and adverse reaction of namefen hydrochloride on the brain of patients with acute craniocerebral injury.Methods: 40 patients with acute craniocerebral injury were randomly divided into two groups: nalmefen hydrochloride group (n = 20) and control group (n = 20).In the treatment group, on the basis of conventional treatment such as lowering intracranial pressure, anti-infection, preventing epilepsy, nutrition support and other routine treatment, the treatment group was treated with namefen hydrochloride 0.2mg/ twice a day for 10 consecutive days, while the control group was the same as the treatment group according to the routine treatment.Namefen hydrochloride was not added to the treatment.Before and after treatment, the serum 尾 -EPN DynA1-3 NSE levels were measured before and after treatment. Heart rate, respiratory frequency and adverse drug reactions were recorded.Results: the level of serum p-EPDynA1-13 NSE in the treatment group was significantly lower than that in the control group, and the overall change trend was decreased, and the decrease of above indexes was 32.44 and 36.91and 4646 at the 10th day of treatment, respectively.The general change trend of 尾 -EPDynA1-13 in the control group was increased, and the increasing range of p-EPDynA1-13 was 11.73and 12.21 at the 10th day of treatment. The overall change trend of NSE in the control group was decreased, and the decrease was 25.45% on the 10th day of treatment.The above three indexes were significantly different between the treatment group and the control group.The abnormal rate of respiration and heart rate in the treatment group was lower than that in the control group, and the difference was significant.There was no significant difference in the number of adverse drug reactions between the two groups.Conclusion: nalmefen hydrochloride can decrease the serum 尾 -EPMA DyIA1-13 NSE level in patients with acute craniocerebral injury, and can alleviate the secondary pathological injury in patients with acute brain injury.It can improve the abnormal rate of heart rate and respiration in patients with acute craniocerebral injury.No aggravation and new adverse reactions occurred after application of nalmefen hydrochloride.6 figures; 13 tables; 58 references.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R651.15

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