沐舒坦对急性呼吸窘迫综合征综合救治的影响

Investigation the Integrative Therapy Effect of Ambroxol in Patients with Acute Respiratory Distress Syndrome

目的研究沐舒坦静脉滴注和静脉待续泵入对急性呼吸窘迫综合征(ARDS)患者综合救治的影响。方法选择ARDS 患者63例,随机分成对照组(A 组20例)和观察组(B 组21例;C 组22例)。3组病人在相同综合救治的基础上 A 组应用生理盐水200ml,B 组应用沐舒坦60mg 加生理盐水200ml 静脉滴注,C 组应用沐舒坦60mg 加生理盐水200ml 静脉持续泵入/24h 连续7d。观察3组病人治疗前后血液中的 IL-6、IL-8浓度,动脉血气分析,肺损伤程度的变化。比较上述指标在治疗前后组内及3组之间的差异,结果 C 组治疗后.病人血液中 IL-6,IL-8浓度,动脉血气分析,肺损伤程度评分较治疗前、B 组和对照组均明显改善(P<0.05或 P<0.01);B 组治疗后,病人血液中 IL-6、IL-8浓度在7d 后较治疗前和对照组均明显降低(P<0.05),动脉血气分析,肺损伤程度评分较治疗前、对照组均明显改善(P<0.05或 P<0.01);而对照组虽然动脉血气有明显改善(P<0 05),但该组病人血清炎症介质浓度和肺损伤程度评分则改变不明显(P>0.05)。结论沐舒坦能在一定程度上抑制炎症介质的释放,减轻急性肺损伤,有利于 ARDS 患者呼吸功能的恢复;静脉持续泵入比静脉滴注效果更好。

Objective To investigate the integrative therapy effect of ambroxol which used as continu intravenous pump or intravenous dripping in patients with acute respiratory distress syndrome （ARDS）. Methods 63 patients with ARDS were divided randomly into three groups, control group （ group A, n - 20） and treatment group （ group B, n = 21 ）, （ group C, n = 22 ）. Patients in group A were treated with 0.9 % NaCl （200 ml） , group B with ambroxol （60 mg） plus 0.9 % NaCl （200 ml） intrvenous dripping once a day for7 days and group C with ambroxol （60 mg） plas 0.9 % NaCl （200 mg） continue pump 24 hours for 7 days . The plasma concentrations of IL-6, IL-8 were measured and blood gas analysis and pulmonary function index were taken, before and after the infusion of 5 days and 7 days respectively. Resuits Compared to group A and group B after treatment with ambroxol in group C, concentrations of IL-6, IL-8, blood gas analysis and pulmonary function index were improved significantly （ P 〈 0.05 orP 〈0.01 ）. After treatment with ambroxol 7 day in group B, concentrations of IL-6, IL-8 were decresed distinctively （ P 〈 0.05 ） compared to before treatment. In group A blood gas analysis and pulmonary function index were much better than those before treatment and in group A （ P 〈 0.05 or P 〈 0.01 ）. Although blood gas analysis improved significantly （ P 〈0.05 ） , concentrations of IL-6, IL-8 and pulmonary function index hadn＇ t significantly change in group A（ P 〉0.05 ）. Conclusion Ambroxol could restrain release of inflammatory media,decrease ALl and improve pulmonary function of patient with ARDS. Continue intravenous pump is better than intravenous dripping.