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背景:脑缺氧缺血可激活一系列生物反应,引起神经元内多种物质的表达变化,从而进一步介导脑组织的损伤,β-内啡肽是否参与了纳洛酮对新生儿缺氧缺血性脑病(hypoxic-ischemicencephalopathy,HIE)治疗的过程,目前研究较少。目的:观察纳洛酮治疗前后血浆β-内啡肽改变,探讨纳洛酮治疗对新生儿HIE的保护作用。设计:以诊断为依据的非随机对照研究。地点和对象:1996-10/1997-10广东医学院附属医院新生儿病房HIE患儿38例(HIE组),男26例,女12例,均为足月儿。25例正常新生儿(正常新生儿组)选自广东医学院附属医院产科婴儿室正常分娩的足月儿,男15例,女10例。干预:38例患儿分别于出生72h内(急性期,治疗前)和7～10d时(恢复期)及25例正常新生儿(出生72h内)血浆β-内啡肽进行检测,并将38例HIE患儿随机分为纳洛组和非纳洛酮组,观察两组的临床疗效及治疗前后血浆β-内啡肽的改变。主要观察指标:各组患儿血浆β-内啡肽的含量。结果:38例HIE患儿急性期血浆β—内啡肽水平较25例正常新生儿显著增高犤(620.35±140.92)ng/L,(373.70±146.69)ng/L,t=6.16,P<0.01犦,恢复期与正常新生儿比较差异无显著性意义犤(335.34±160.37)ng/L,(373.70±146.69)ng/L,P>0.05犦。纳洛酮组与非纳洛酮组治疗前后血浆β-内啡肽浓度差值比较未见?
BACKGROUND: Hypoxic-ischemic brain can activate a series of biological reactions, which cause the changes of many substances in neurons. It further mediates the damage of brain tissue. Whether β-endorphin is involved in the hypoxia of naloxone There are few studies on the treatment of ischemic encephalopathy (HIE). Objective: To observe the changes of plasma β-endorphin before and after naloxone treatment and to explore the protective effect of naloxone on neonatal HIE. Design: A non-randomized controlled study based on diagnosis. Place and subject: 1996-10 / 1997-10 38 neonates with HIE in the affiliated hospital of Guangdong Medical College (HIE group), 26 males and 12 females, all of whom were full-term infants. Twenty-five normal neonates (normal neonates) were selected from full-term infants born in the obstetric infant room of Guangdong Medical College Affiliated Hospital, 15 males and 10 females. Intervention: Plasma β-endorphin levels were measured in 38 infants within 72 hours of birth (acute phase, before treatment) and 7-10 days (recovery phase) and 25 normal newborns (within 72 hours of birth), respectively. Cases of HIE children were randomly divided into naloxone group and non-naloxone group, the clinical efficacy and changes of plasma β-endorphin before and after treatment were observed. MAIN OUTCOME MEASURES: The content of plasma β-endorphin in children in each group. Results: Plasma levels of β-endorphin in 38 HIE children were significantly higher than those in 25 normal newborns (620.35 ± 140.92 ng / L, 373.70 ± 146.69 ng / L, t = 6.16, P <0.01 There was no significant difference between the convalescence and normal newborns (335.34 ± 160.37 ng / L, 373.70 ± 146.69 ng / L, P> 0.05). Naloxone group and non-naloxone group before and after treatment, plasma β-endorphin concentration difference was not seen?