重庆医学2013，Vol.42Issue(2)：160-162,166,4.DOI:10.3969/j.issn.1671-8348.2013.02.013
纳美芬对脑肿瘤术后患者血浆皮质醇、促肾上腺皮质激素及葡萄糖水平的影响
Effects of nalmefene on postoperative plasma cortisol,adrenocorticotropic hormone and glucose levels of patients with brain neoplasms
邓民强 1田仁副 1潘柯 1周晗 1姜清泉 1向飞1
作者信息
- 1. 湖北省恩施州中心医院神经外科,湖北恩施,445000
- 折叠
摘要
Abstract
Objective To investigate effects of nalmefene on postoperative plasma cortisol, adrenocorticotropic hormone (ACTH) and glucose levels of patients with brain neoplasms.Methods 185 patients with brain neoplasms who accepted surgical treatment were divided into conventional treatment group (n = 90, accepted conventional treatment after surgery) and nalmefene treatment group (ｎ= 95,administrated with nalmefene 8μg·kg-1·d-1 by intravenous infusion for 6 days on the basis of conventional treatment after surgery) according to therapeutic regimen.44 patients with brain neoplasms hospitalized during the same period who had not yet accepted intracranial surgery were selected and served as control group.Plasma cortisol, ACTH and glucose concentration of patients were detected on day 2(d2),day 4(d4),day 6(d6) after nalmefene administration.Glasgow coma scale (GCS) scores and Barthel index scores were adopted to assess nerve function on day 3,day 5,day 7,day 17 and day 60 after surgery,and Karnofsky's performance status(KPS) scores were employed for evaluation of long-term efficacy on day 90 after surgery.Results Except time point of d6,plasma cortisol,ACTH,glucose concentrations of patients in conventional treatment group and nalmefene treatment group were significantly higher than those in control group on the rest of time points(P<0.05).On d2,d4 and d6,plasma cortisol,ACTH,glucose concentrations of patients in nalmefene treatment group were markedly lower than those in conventional treatment group(P<0.05).Taking GCS score value on day 3 as the base, cumulative rises of consciousness level of patients in nalmefene treatment group were significantly superior to those in conventional treatment group(P<0.05).Nerve function improvement( Barthel index score) on day 4 and day 6 after surgery as well as long-term prognosis(KPS score) on day 90 of patients in nalmefene treatment group were obviously superior to those in conventional treatment group(P<0.05).Conclusion Postoperative administration of nalmefene can significantly decrease levels of plasma cortisol, ACTH, glucose, and markedly improve prognosis of patients.关键词
脑肿瘤/应激/皮质醇/促肾上腺皮质素/葡萄糖Key words
brain neoplasms/stress/cortisol/adrenocorticotropic hormone/glucose引用本文复制引用
邓民强,田仁副,潘柯,周晗,姜清泉,向飞..纳美芬对脑肿瘤术后患者血浆皮质醇、促肾上腺皮质激素及葡萄糖水平的影响[J].重庆医学,2013,42(2):160-162,166,4.
