主页 > 医学讨论 >
【medical-news】脑外伤后长期使用布洛芬镇痛可能
Possible implications for traumatic brain injury patients
(Philadelphia, PA) -- Researchers at the University of Pennsylvania School of Medicine found that chronic ibuprofen therapy given after brain injury worsens cognitive abilities. These findings ?in a preliminary, animal-model study ?have important implications for traumatic brain injury (TBI) patients who are often prescribed such nonsteroidal anti-inflammatory drugs (NSAIDS) as ibuprofen for chronic pain. The findings appear online this month in Experimental Neurology.
Because several studies in animals and humans have shown that long-term use of ibuprofen for inflammation improves outcome for Alzheimer's patients by reducing symptoms and delaying the onset of dementia, the researchers investigated whether ibuprofen improved long-term cognitive outcome in brain-injured animals.
Over four months, rats received ibuprofen in their food proportional to doses given to humans. In the two groups of injured rats (one fed ibuprofen and the other not), there was a significant overall deficit in the animals' ability to find an underwater platform in a Morris water maze, a common test used to assess cognitive ability in animals.
"But to our surprise, we found that the injured rats given ibuprofen were far worse compared to the injured rats that had no treatment at all," says lead author Douglas H. Smith, MD, Director of the Center for Brain Injury and Repair. "Although most untreated injured animals could find the platform, they were much slower to learn its location than non-injured animals. In contrast, almost none of the treated, injured animals could find the platform at all."
However, there were no outward signs of difference in the extent of atrophy in the hippocampus or cortex of treated versus non-treated injured rats. Although ibuprofen treatment did reduce chronic inflammatory changes in the brains of injured animals, that did not seem to have an influence over the extent of damage to the brain regions associated with learning and memory.
This initial study demonstrates that the effects of long-term treatment with NSAIDS like ibuprofen after a head injury are poorly understood. "We have to remember these are animal studies, and what we can take home is that we need further examination of potential negative effects in patients," says Smith. "I hope these findings inspire studies in patients to evaluate the safety, efficacy, and potential long-term problems with cognition of chronic ibuprofen use in TBI patients."
In Alzheimer's patients, chronic ibuprofen appears to be beneficial by delaying onset and severity of symptoms. Similarly, chronic ibuprofen therapy in a mouse model of Alzheimer's disease reduces plaque build-up in the brain and improves function. However, finding that this same approach to treatment worsens the outcome in an animal model of TBI may have important implications for TBI patients who are often prescribed NSAIDS for chronic pain. With few alternative over-the-counter pain medicines available to these patients, further investigation is essential, says Smith. 动物实验中脑损伤后长期布洛芬疗法可损伤认知功能
―――――――――对外伤性脑损伤可能的提示
（费城）宾西法尼亚大学医学院研究人员发现脑损伤后长期布洛芬疗法会损害认知功能。这些发现（在一个初步的动物模型研究中）对经常应用非甾体抗炎药如布洛芬治疗慢性疼痛的外伤性脑损伤患者具有重要的提示作用。这些发现发表在本月《实验神经病学》网络版中。
因为少数的动物和人类研究已经表明长期应用布洛芬治疗炎症可以通过减少症状和延迟发生痴呆来提高患者的临床治疗效果，所以研究人员探索布洛芬是否可以改善脑损伤动物的远期认知功能。
在长达4个月中，试验鼠在它们的食物添加剂中放入与人类服用剂量相等的布洛芬。在两组受损伤的实验鼠中（一组接受布洛芬治疗，一组不接受），在morris水下迷宫（在动物中用来测试认知能力的一个常用实验）中寻找水下平台的能力方面都表现出明显缺陷。
“但是令我们吃惊的是，我们发现与根本没有接受治疗的受损伤鼠相比，接受布洛芬的受损伤鼠认知能力更差。”脑损伤与修复中心领导之一Douglas H. Smith博士说。
“尽管大多数未治疗得动物能够发现那个平台，但是它们与未受伤的动物相比要慢得多。相比而言，几乎没有一个经过治疗的受损伤动物能够找到那个平台。”
然而，经治疗鼠与未经治疗鼠相比，在海马与皮质萎缩程度方面没有外在的差异。尽管布洛芬治疗确实减少受损伤动物脑的慢性炎症改变，但是这不能表明它对学习和记忆脑功能区的损害程度有影响。
这个初级的研究表明，脑损伤后长期应用非甾体抗炎药如布洛芬的效果不是很清楚。“我们必须记住这是动物实验，我们能够应用的是我们需要更多的实验研究在病人中的潜在作用。”Smith说。
阅读本文的人还阅读：
作者:admin@医学,生命科学 2011-02-18 05:14
医学,生命科学网