【作者】 刘杰；

【导师】 孟庆海；

【作者基本信息】 青岛大学 ， 神经外科， 2005， 硕士

【摘要】 目的 探讨颅脑伤后早期应用纳洛酮对改善垂体前叶激素和甲状腺激素紊乱及其临床意义。 方法 选择颅脑伤入院患者40例分为常规治疗组和纳洛酮治疗组,另取10例作为正常对照。分别测定其入院时、入院后第1天、第2天、第3天的垂体前叶激素和甲状腺激素水平,并对结果进行统计学处理。 结果 常规治疗组脑外伤患者急性期血清PRL、FSH、LH、TSH均升高（较正常对照组P<0.01）;FT₃下降明显（较正常对照组P<0.01）,FT₄亦有不同程度升高（较正常对照组P<0.05）。而纳洛酮治疗组PRL、FSH、LH、TSH变化较常规治疗组有显著差异（P<0.01）,尤以入院后第1天、第2天明显;GH变化纳洛酮组较常规治疗组差异无显著性。纳洛酮治疗组FT₃变化较常规治疗组差异有极显著意义（P<0.01）;FT₄升高有显著意义（P<0.05）。 结论 颅脑损伤可导致下丘脑-垂体-甲状腺轴功能异常,引起垂体前叶激素及甲状腺激素分泌紊乱;而脑外伤后早期应用纳洛酮则可通过减轻脑水肿,促进脑组织代谢等机制发挥脑保护作用,减轻下丘脑-垂体-甲状腺轴的损伤及其继发的病理损害,从而改善内分泌激素的紊乱,有助于颅脑损伤的恢复。更多还原

【Abstract】 Objective To study the effective of early application of Naloxone in treatment of brain injury on improving anterior pituitary hormones and thyroid hormones.Methods The 40 patients were divided into the control group and Naloxone group. The anterior pituitary hormone and thyroid hormone were examined at the point of being hospitalized, thelth day, the 2th day and the 3th day of the patients, the result were analysed statistically. Another 10 normal person’s anterior pituitary hormone and thyroid honnone were examined as normal control group.Results The serum PRL, FSH, LH, TSH of control group were higher than normal group(P<0.01); the serum FT3 of control group were lower than normal control(P<0.01); the serum FT4 were higher than normal control(P<0.05). The serum PRL, FSH, LH, TSH of Naloxone group were significantly difference than the control group(P<0.01), especially the lth day and the 2th day after being hospitalized. There was no statistically difference in GH between the Naloxone group and the control group. FT3 of Naloxone group were remarkable significantly difference than the control group(P<0.01). Higher FT4 were significantly difference between the Naloxone group and the control group(P<0.05).Conclusion Brain injury could result in the function change of hypothalamus-pituitarium-thyroxine axle, cause unusual of anterior pituitary hormones and thyroid hormones. This data has confirmed that Naloxone could reduce the pathological lesion of hypothalamus- pituitarium-thyroxine axle through relieving the brain edema, promoting the metabolism of brain,and then correcting the unusual of endocrine function, improving the recovery in severe brain injuries.更多还原