氨溴索对肺癌患者放射性肺损伤的保护效应

Protective effects of ambroxol on radiation lung injury in patients with advanced lung cancer

目的探讨氨溴索对肺癌患者放射性肺损伤的保护作用。方法进展期肺癌放射治疗(放疗)患者120例随机均分为两组:A组放疗期间静脉滴注氨溴索90mg/d,连续20d;B组单纯放疗。放疗前后测定TNF-α和转化生长因子β1(TGF-β1)水平。观察临床症状、肺一氧化碳弥散量(DLCO)和肺部影像学改变。结果放疗后,A组DLCO下降幅度小于B组(P<0.05),放射性肺纤维化发生率也低于B组(P<0.05)。放疗后,A组血浆TNF-α和TGF-β1表达量均低于B组[(2.43±0.83)ng/ml vs.(5.62±2.64)ng/ml和(5.56±1.21)ng/ml vs.(11.83±5.54)ng/ml](P<0.01)。两组患者均未出现明显肝、肾损害等不良反应。结论氨溴索可能通过抑制放疗后血浆TNF-α和TGF-β1的过度表达而减轻肺癌患者放射性肺损伤。

Objective To investigate the protective effects of ambroxol on radiation lung injury in the patients with advanced lung cancer. Methods A total of 120 patients with locally advanced lung cancer under radiotherapy was equally randomized into two groups of A（injected daily with ambroxol 90 nag for 20 days） and B （without ambroxol as the control）. The expressions of TNF-α and transforming growth factor β1（TGF-β1） in plasma were detected with ELISA. The clinical symptoms and pulmonary diffusion function （DLCO） were tested using high resolving power computed tomography. Results The amplitude in the decrease of DLCO more than 25% was less in group A than that in group B（P〈0. 05）. The incidence rate of pulmonary fibrosis after radiotherapy was lower in group A than that in group B （P〈0. 05 ）. Plasma expressions of TNF-α and TGF-β1 after radiotherapy were significantly lower in group A than those in group BE（2.43±0.83） ng/ml vs. （5.62 ±2.64） ng/ml and （5.56±1.21） ng/ml vs. （11.83±5.54） ng/ml（P〈0. 01）. There were no severe adverse effects related to the use of ambroxol in hepatic or renal damages in both groups. Conclusion Ambroxol may reduce the radiation lung injury possibly via inhibiting the increases of TGF-β1 and TNF-α expressions in the patients with advanced lung cancer.