Thornton J R, Losowsky M S
Department of Medicine, St James's University Hospital, Leeds.
BMJ. 1988 Dec 10;297(6662):1501-4. doi: 10.1136/bmj.297.6662.1501.
Patients with liver disease have increased plasma concentrations of the endogenous opioid peptides methionine enkephalin and leucine enkephalin. As an initial investigation to determine whether opioid peptides contribute to any of the clinical manifestations of hepatic disease nalmefene, a specific opioid antagonist devoid of agonist activity, was given to 11 patients with cirrhosis. They all experienced a severe opioid withdrawal reaction on starting the drug. In the nine patients with primary biliary cirrhosis pruritus was greatly alleviated, fatigue seemed to improve, and plasma bilirubin concentration, which had been rising, showed a modest fall in all except one patient. These results indicate that blocking opioid receptors has an effect on some of the metabolic abnormalities of liver disease.
肝病患者血浆中内源性阿片肽甲硫氨酸脑啡肽和亮氨酸脑啡肽的浓度升高。作为确定阿片肽是否与肝病的任何临床表现有关的初步研究，对11名肝硬化患者给予了无激动剂活性的特异性阿片拮抗剂纳美芬。他们在开始用药时均出现了严重的阿片戒断反应。在9名原发性胆汁性肝硬化患者中，瘙痒得到了极大缓解，疲劳似乎有所改善，一直上升的血浆胆红素浓度在除1名患者外的所有患者中均有适度下降。这些结果表明，阻断阿片受体对肝病的某些代谢异常有影响。
