Effects Of Naloxone On VEGF、bFGF And Neurological Recovery In Patients With Acute Cerebral Stroke

Objective:Vascular endothelial growth factor(VEGF) and basic fibroblast growth factor(bFGF) are endothelial cell-specific mitogen.VEGF expression in normal tissues is not obvious, but in some pathophysiological state, especially during hypoxia, VEGF levels were significantly increased.In this case VEGF can play a role in the central nervous system by causing neovascularization effects, promoting angiogenesis, adjusting vascular permeability, increasing local blood supply. bFGF is a multi-effectiveness growth factor, what has a significant role in promoting value-added for cells that from mesoderm and neural ectoderm,and can promote the survival activation of the glial cells, vascular endothelial cell and the formation of new capillaries.Under the stimulate of ischemia and hypoxia,bFGF also can cause the neurons to avoid necrosis and apoptosis by promoting neuronal survival,neurite out growth and the maturation of neural stem cells.This shows that after acute cerebral stroke,the expression levels of VEGF and bFGF can affect the angiogenesis and the ability of nerve function recovery,while the naloxone is currently recognized as a novel neuroprotective agents.So the objective of this study is to investigate the effects of naloxone on VEGF,bFGF and Neurological recovery in patients with acute cerebral stroke.Methods:160 patients with acute ischemic cerebral stroke were completely randomized into a control group and naloxone group,80 cases each.The control group received improving circulation,neurotrophic, anti-platelet aggregation and lipid-lowering drug therapy in accordance with its incidence and concurrent diseases.On the basis of control group,the naloxone group were treated with naloxone 2.4mg + 0.9% Na Cl 250 mL i.v 1 times /day, continuous application of 14 days.After admission 1,7and 14 days,both groups were extracted decubitus venous blood,then determinate the level of serum vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(bFGF)using enzyme-linked immunosorbent assay(ELISA); after 1,7,14 days scored the neural function defect scale by the US National Institutes of Health stroke Scale(NIHSS) and Activities Of Daily Living Assessment(ADL).Results:1.Naloxone group can higher increase the expression of VEGFand bFGF than the control group(P<0.05);2. The level of VEGF and bFGF in the control group has peak at 7th day, then has declined at 14 th days; naloxone group peak expression of can be maintained to 14 th days;3.Naloxone group can significantly reduce NIHSS value of neurological deficit scores than the control group(P<0.05);4. Naloxone group improved the quality of life by increasing the ADL scores significantly,compared with the control group(P<0.05);5.NIHSS scores and VEGF,bFGF expression levels exist negative correlation, namely the NIHSS score is lower when the level of VEGF and bFGF is higher.Conclusion:As a novel neuroprotective agent,naloxone can significantly increase the expression of VEGF and bFGF in the serum of patients with cerebral stroke to improve the degree of neurological deficit and blood supply status, reduce disability and improve quality of life.