目的 探讨纳洛酮联合亚低温对急性CO中毒迟发性脑损伤脑神经功能改善的作用。方法 选取本院诊治的急性CO中毒迟发性脑损伤患者63例,采用随机数字表法分为A、B、C三组,采用相关工具评定患者的昏迷状况、日常生活能力及患者的运动功能,比较三组患者的治疗效果、不良事件情况。结果 治疗后,三组患者GCS评分、日常生活能力评分、运动功能评分均升高。治疗效果:B组高于A组,C组高于A组和B组,不良事件发生率:B组低于A组,C组低于A组和B组,差异均有统计学意义(P＜0.05)。结论 纳洛酮联合亚低温治疗可明显改善急性CO中毒迟发性脑损伤患者的脑神经功能,可提高患者的日常生活能力与运动功能,治疗效果好且不良事件少,有较高的安全性,值得临床推广使用。

目的 探讨小脑延髓池注射纳洛酮对心肺复苏大鼠脑神经保护的作用机制。方法 将30只雄性SD大鼠随机分为假手术组、常规复苏组和纳洛酮复苏组。采用窒息法建立大鼠心脏骤停模型,复苏的同时给予药物治疗。恢复自主循环(ROSC)后24 h取脑组织,荧光定量PCR法检测脑组织c-Fos mRNA表达水平,免疫组化法检测脑组织c-Fos蛋白的表达。结果 与常规复苏组比较,纳洛酮可显著降低大鼠脑组织c-Fos mRNA及蛋白表达量(P<0.01)。结论 小脑延髓池注射纳洛酮可及时有效的作用于c-Fos基因,发挥脑神经保护作用。

Objective To investigate the neuroprotective mechanism of naloxone injected into cisterna magna on cerebral ischemia-reperfusion. Methods Thirty adult male SD rats were randomly divided into sham group, conventional cardiopulmonary resuscitation (CPR) group and naloxone CPR group. Asphyxiation was used to set up rat cardiac arrest model, and corresponding drugs were given when the resuscitation was carried out. The Brain tissues were taken at 24 h after restoration of spontaneous circulation(ROSC). Fluorescence quantitative polymerase chain reaction (PCR) and immunohistochemical was used to detect the expression of c-Fos proteins was used to detect the expression of c-Fos mRNA level. Results Compared with the conventional CPR group, Naloxone could significantly decrease the expression of c-Fos protein and c-Fos mRNA in rat brain. Conclusion Naloxone injected into cisterna magna can promptly and effectively act on c-Fos gene, playing a neuroprotective role.