盐酸氨溴索治疗对COPD患者细胞因子和肺功能的影响

Effects of ambroxol hydrochloride on cytokines and lung function in patients with chronic obstructive pulmonary disease

目的探讨盐酸氨溴索治疗对慢性阻塞性肺疾病(COPD)患者细胞因子和肺功能的影响。方法 COPD急性加重期患者92例随机均分为两组:B组采用常规治疗;A组加用盐酸氨溴索1.2-1.6mg·kg-1·d-1,每天分2-3次缓慢静脉注射。比较两组患者IL-8、IL-10、C-反应蛋白(CRP)和TNF-α等细胞因子以及肺功能的情况。结果两组治疗后IL-8、IL-10、CRP和TNF-α均低于治疗前(P<0.05);A组治疗后IL-8、IL-10、CRP和TNF-α均低于B组(P<0.05)。两组患者治疗后的第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占用力肺活量的百分比(FEV1/FVC)和第1秒用力呼气容积占预计值百分比(FEV1%Pred)均高于治疗前(P<0.05);A组患者治疗后的FEV1、FEV1/FVC和FEV1%Pred均高于B组(P<0.05)。结论在常规治疗基础上加用盐酸氨溴索治疗可降低COPD急性加重期患者血清炎性细胞因子水平,减轻呼吸道炎症反应,改善呼吸功能。

Objective To investigate the influence of ambroxol hydrochloride on the cytokines and lung funetioh in the 15atients with chronic obstructive pulmonary disease （COPD）. Methods A total of 92 COPD patients with acute exacerbations was randomly and equally assigned into two groups of A（treated with conventional therapy plus infusion of ambroxol 1.2-1.6 mg · kg-1 · d-1 , 2-3 times a day） and B（treated with conventional therapy alone）. Serum concentrations of IL-8, IL-10, C-reactive protein（CRP） and TNF-α were detected with ELISA and colloidal gold method before and during stable disease after treatment. The lung functions were examined and compared between two groups as well. R^ults Serum concentrations of IL-8, IL-10, CRP and TNF-α were significantly lower after treatment than those before in both groups（P〈0. 05）, which were lower in group A than those in group B after treatment（P〈0. 05）. The forced expiratory volume in one second（FEV1 ）, the ratio of FEV1 to forced vital capacity（FEV1/FVC） and the ratio of FEV1 to predicted value（FEV1 % Pred） were significantly higher after treatment than those before in both groups（P〈0. 05）, which were higher in group A than those in group B after treatment （P〈0. 05）. Conclusion On the basis of conventional therapy, additional use of ambroxol hydrochloride may reduce serum levels of inflammatory cytokines, attenuate airway inflammatory reaction and improve pulmonary function in the patients with COPD.