术前使用沐舒坦对体外循环术后肺损伤的影响

Impact of Infusing Ambroxol Before Cardiopulmonary Bypass upon Lung Injury

【目的】观察体外循环()CPB手术前使用沐舒坦对急性肺损伤的保护作用,并探讨其机制。【方法】60例先天性心脏病患儿,随机分成三组:实验组(甲组,n=20)于CPB前30min静推沐舒坦30mg;对照Ⅰ组(乙组,n=20)于CPB后静脉推注沐舒坦30mg;对照Ⅱ组(丙组n=20)不用任何呼吸系统药物。分别于CPB前,CPB后3h测量肺泡-动脉氧分压差(A-aDO2),动脉血超氧化物歧化酶/丙二醛(SOD/MDA)值。【结果】实验组术后A-aDO2明显高于对照Ⅱ组(P<0.05),但与对照Ⅰ组相比差异无显著性(P>0.05)。实验组SOD水平明显高于对照Ⅱ组(P<0.05),MDA水平明显低于对照组。【结论】体外循环手术前静脉使用沐舒坦(30mg)可以减轻术后肺损伤。

[Objective]To study the protective effect and mechanism of Ambroxol against lung injury after cardiopulmonary bypass（CPB）. [Methods]Sixty children with congenital heart disease were divided into three groups randomly： treating group （ groupA, n= 20）, given ambroxol 30mg preopreatively ; control group 1 （ group B n =20）given ambroxol 30mg postoperatively; while the control group 2 given nothing. A-aDO2 was measured before CPB and 3h after CPB. SOD/MDA values in the artery were measured before and 3h after CPB. [Results]A-aDO2 value in the treating group was lower than in the control group 2; the SOD value was significantly higher, whereas MDA value was significantly lower in the treating group than those in the control group 2,3h after CPB. [Conclusion]Infusing ambroxol（30 mg） before CPB has protective effect on lung injury. The present study indicates that the protective effect may be related to the enhanced ability against lipid peroxidation.