沙美特罗替卡松粉吸入剂预防急性高原病的作用研究

Empirical study of salmeterol xinafoate and fluticasone propionate powder for inhalation as prophylaxis against acute mountain sickness

目的观察沙美特罗替卡松粉吸入剂(SM/FP)预防急性高原病(AMS)的效果。方法 34名男性官兵随机分为SM/FP组(n=18)和对照组(n=16),均自海拔1400m历时5d进入海拔5200m高原。从进驻5200m当天开始,SM/FP组每天早晚吸入SM/FP(沙美特罗100μg,丙酸氟替卡松200μg),对照组喷入生理盐水,连续5d。按国军标GJB1098-91《急性高原反应的诊断和处理原则》标准,观察第1、3、5d急性高原反应的严重程度、SaO2和心率;进驻海拔5200m第5d采血,检测超氧化物歧化酶(SOD)、丙二醛(MDA)、血乳酸(BLA)、一氧化氮(NO)及其合酶(NOS)。结果进入海拔5200m第1、3、5d时,SM/FP组急性高原反应分值较对照组降低(P<0.01),SaO2增高(P<0.05),HR无显著差异(P>0.05);SM/FP组较对照组SOD、NO、NOS增高,MDA、BLA降低(P<0.01或P<0.05)。结论吸入SM/FP可改善高原低氧血症,降低急性高原反应的发病率,增强机体抗氧化酶活性和乳酸清除能力。

Objective To observe the preventive effects of salmeterol xinafoate and fluticasone propionate powder for inhalation （SM/FP）on acute mountain sickness（AMS）. Methods 34 young male were randomly divided into SM/FP group （n = 18） and control group （n = 16） in this double blind and placebo - controlled trial. All of them had spent five days before arriving at high altitude of 5400 m from 1400 m above sea level. Since the day when they arrived at 5400 m high altitude,SM/FP group inhaled SM/FP （100 μg salmeterol and 200 μg fluticasone propionate） and the control group inhaled small amount of placebo （0.9% sodium chloride） twice daily for 5 d. According to National Military Criteria GJB1098 - 91 Principles for Diagnosis and Treatment of Acute Mountain Sickness, the acute high altitude reaction in the two groups were observed and scored on day 1,3 and 5, respectively. Meanwhile, their arterial oxygen saturation （ SaO2 ） and heart rates were recorded. On day 5 after the subjects arrived at 5200 m high altitude, their blood samples were collected to measure superoxide dismutase （SOD）, malondialdehyde （MDA）, blood lactic acid （BLA） , NO and nitric oxide synthase （NOS）levels. Results The score of acute high altitude reaction significantly reduced （P 〈 0. 01 ） and SaO2 significantly increased in SM/FP group （P 〈 0. 05 ） on day 1,3 and 5 compared with control group, but HR had no significant difference between the two groups. Meanwhile, the levels of SOD, NO and NOS levels increased and MDA and BLA reduced in SM/FP group compared with those in the control group （P 〈 0.05 or P 〈 0. 01 ）. Conclusion SM/FP can improve hypoxemia,lower the incidence of acute high altitude reaction, enhance the activity of antioxidase and strengthen the capacity of lactic acid cleaning.