Chernick V, Manfreda J, De Booy V, Davi M, Rigatto H, Seshia M
Department and Pediatrics, University of Manitoba, Winnipeg, Canada.
J Pediatr. 1988 Sep;113(3):519-25. doi: 10.1016/s0022-3476(88)80645-0.
To determine whether endogenous opiates play a role in the pathogenesis of perinatal asphyxia, a blinded clinical trial of naloxone, a competitive opiate receptor blocker, was undertaken in infants with low 1-minute Apgar scores. Of 85 infants with 1-minute Apgar score 0 to 3, 44 received an injection of naloxone (approximately 0.4 mg/kg) and 41 received saline solution. In 108 infants with 1-minute Apgar score 4 to 6, 54 received naloxone and 54 saline solution. In neither group was there a significant effect of naloxone on respiratory frequency or heart rate up to 30 minutes after injection, nor at 24 hours of age. In both groups active muscle tone of upper and lower limbs was increased by naloxone, a response that may not be beneficial in the face of inadequate oxygen delivery to vital organs. We conclude that naloxone at this dose had no readily apparent benefit in the resuscitation of the asphyxiated newborn infant.
为了确定内源性阿片类物质是否在围产期窒息的发病机制中起作用，对1分钟阿氏评分低的婴儿进行了一项关于纳洛酮（一种竞争性阿片受体阻滞剂）的双盲临床试验。在85名1分钟阿氏评分为0至3分的婴儿中，44名接受了纳洛酮注射（约0.4mg/kg），41名接受了生理盐水注射。在108名1分钟阿氏评分为4至6分的婴儿中，54名接受了纳洛酮，54名接受了生理盐水。注射后30分钟内及24小时龄时，两组中纳洛酮对呼吸频率或心率均无显著影响。在两组中，纳洛酮均增加了上下肢的主动肌张力，面对重要器官氧输送不足时，这种反应可能并无益处。我们得出结论，该剂量的纳洛酮对窒息新生儿的复苏没有明显益处。
