本文選題：鹽酸納美芬 + 顱腦損傷　； 參考：《中南大學(xué)》2013年碩士論文

【摘要】：目的：研究急性顱腦外傷患者應(yīng)用鹽酸納美芬后血清p-內(nèi)啡肽(p-EP)、強(qiáng)啡肽(DynA1-13)、神經(jīng)元特異性烯醇化酶(NSE)的變化,評價鹽酸納美芬對急性顱腦損傷患者的腦保護(hù)作用及不良反應(yīng)。方法：選取急性顱腦損傷患者40例,并隨機(jī)分為鹽酸納美芬治療組和對照組各20例。治療組在降顱壓、抗感染、預(yù)防癲癇、營養(yǎng)支持等常規(guī)治療的基礎(chǔ)上加用鹽酸納美芬0.2mg/次,每天2次靜脈滴入,連續(xù)應(yīng)用10天；對照組按照常規(guī)治療與治療組相同,不加用鹽酸納美芬治療。所有患者在治療前以及治療后第1、2、3、5、7、10天測定血清β-EP、DynA1-3、NSE的含量,同時記錄患者的心率、呼吸頻率變化及藥物不良反應(yīng)。結(jié)果：治療組的血清p-EP、DynA1-13、NSE的含量明顯低于對照組,其總體變化趨勢是下降,到治療第10天時以上指標(biāo)的下降幅度分別為32.44%、36.91%、46%。對照組的β-EP、DynA1-13的總體變化趨勢是升高,到治療第10天時p-EP、DynA1-13的升高幅度分別為11.73%、12.21%,對照組的NSE總體變化趨勢是下降,到治療第10天時下降幅度為25.45%。以上三個指標(biāo)在治療組與對照組中均有顯著差異。治療組的呼吸異常率及心率異常率均低于對照組,差異顯著。兩組治療過程中出現(xiàn)的藥物不良反應(yīng)患者例數(shù)未發(fā)現(xiàn)有顯著差異。結(jié)論：鹽酸納美芬可降低急性顱腦損傷后患者血清β-EP、DyIA1-13、NSE的含量,能減輕急性顱腦損傷患者的繼發(fā)性病理損傷,有一定的腦保護(hù)作用,并可改善急性顱腦損傷患者的心率異常率和呼吸異常率。應(yīng)用鹽酸納美芬后未加重和出現(xiàn)新的不良反應(yīng)。圖6幅；表13個；參考文獻(xiàn)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.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R651.15

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 江基堯;;β-內(nèi)啡肽與中樞神經(jīng)系統(tǒng)損傷的研究進(jìn)展[J];國外醫(yī)學(xué).神經(jīng)病學(xué)神經(jīng)外科學(xué)分冊;1988年05期

2 洪濤;劉道坤;;強(qiáng)啡肽與中樞神經(jīng)系統(tǒng)損傷[J];國外醫(yī)學(xué).神經(jīng)病學(xué)神經(jīng)外科學(xué)分冊;1992年01期

3 王一芳;急性脊髓損傷中的血管機(jī)制及其治療[J];國外醫(yī)學(xué).神經(jīng)病學(xué)神經(jīng)外科學(xué)分冊;1998年04期

4 朱海兵;溫預(yù)關(guān);黃河清;;鹽酸納美芬的藥理作用及臨床應(yīng)用[J];廣州醫(yī)藥;2008年04期

5 刁云鋒;涂悅;張賽;;納美芬治療急性重型顱腦創(chuàng)傷的療效分析[J];醫(yī)藥論壇雜志;2011年12期

6 蘇俊峰;納美芬對急性乙醇中毒的實驗治療[J];解放軍醫(yī)學(xué)雜志;2000年06期

7 任愛國;納美芬的藥理作用及臨床應(yīng)用概況[J];解放軍醫(yī)學(xué)情報;1996年02期

8 王世英;阿片肽研究的回顧和展望[J];生物學(xué)通報;2001年01期

9 陳鐘黎;;納洛酮腦保護(hù)作用的研究現(xiàn)狀[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2009年06期

10 屈洪艷;彭翔;蔡潤;;顱腦損傷患者血清NSE的含量變化及臨床意義[J];中國臨床神經(jīng)外科雜志;2007年12期

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