Reece Albert Stuart
University of Queensland, Medical School, 39 Gladstone Road, Highgate Hill, Brisbane, Queensland, 4101, Australia.
BMJ Case Rep. 2009;2009:bcr0820080799. doi: 10.1136/bcr.08.2008.0799. Epub 2009 Apr 14.
Here the dramatic and rapid response of a 54-year-old obese hypertensive man with poorly controlled insulin-dependent diabetes with a 33 year history of high dose heroin use, a 1 year history of refractory ulceration of his hands, ankles and feet, treated coronary artery disease, and the metabolic syndrome, to implantation with long-acting naltrexone implants is presented. In particular his hyperlipidaemia, hyperglycaemia, proinflammatory state, evidence of hepatic and renal insufficiency, arterial stiffness, and extensive and chronic cutaneous ulceration all improved dramatically over just 13 weeks, in association with complete control of his heroin, benzodiazepine, tobacco and cannabis use. The metabolic and vascular benefits were all highly statistically significant. The case is the first to document dramatic and rapid metabolic, immune and vascular improvements in association with clinical naltrexone therapy and are consistent with its likely effects in restoring addiction-related stem cell and immunological deficits.
本文介绍了一名54岁肥胖高血压男性患者的显著快速反应。该患者患有胰岛素依赖型糖尿病且控制不佳,有33年高剂量海洛因使用史,手部、脚踝和足部难治性溃疡1年,接受过冠状动脉疾病治疗,还患有代谢综合征。在植入长效纳曲酮植入剂后,他的高脂血症、高血糖、促炎状态、肝肾功能不全证据、动脉僵硬以及广泛慢性皮肤溃疡在短短13周内均有显著改善,同时他的海洛因、苯二氮卓类药物、烟草和大麻使用得到了完全控制。代谢和血管方面的益处均具有高度统计学意义。该病例首次记录了与临床纳曲酮治疗相关的显著快速代谢、免疫和血管改善情况,这与其在恢复成瘾相关干细胞和免疫缺陷方面的可能作用相一致。