STUDIES OF THE OPIATE SYSTEM IN CHOLESTATIC LIVER DISEASE

一种用于连续量化划痕活动的新系统已经被 精心设计的。这一系统允许客观地定量研究 胆汁淤积性瘙痒的治疗效果观察 承担了。使用这一系统，纳洛酮输液已被证明 由于以下原因导致瘙痒患者的抓挠活动减少约50% 原发性胆汁性肝硬变，提示阿片系统可能是 与胆汁淤积性瘙痒的调停有关。大鼠有 由于胆管结扎引起的急性胆汁淤积症已经被证明有轻微的 用甩尾法评价其镇痛状态。这种止痛药可以 被纳洛酮逆转。这些发现与本病的症状相一致。 胆汁淤积与阿片能张力增加和 胆汁淤积的某些并发症，如瘙痒， 可能由中枢阿片受体介导，并可通过 给药时有效的阿片受体拮抗剂 口服(例如，纳美芬)。

A new system for continuously quantitating scratching activity has been devised. This system permits objective quantitative studies of the effectiveness of therapies for the pruritus of cholestasis to be undertaken. Using this system naloxone infusions have been shown to decrease scratching activity by about 50% in patients with pruritus due to primary biliary cirrhosis, suggesting that the opiate system may be implicated in the mediation of the pruritus of cholestasis . Rats with acute cholestasis due to bile duct ligation have been shown to have a mild analgesic state as evaluated with the tail flick assay. This analgesia can be reversed by naloxone. These findings are consistent with the syndrome of cholestasis being associated with increased opiatergic tone and raise the possibility that certain complications of cholestasis, such as pruritus, may be mediated by central opiate receptors and alleviated by the administration of opiate receptor antagonists that are effective when given orally (e.g.nalmefene).