氨溴索对AECOPD合并呼衰患者血气指标及炎症因子的影响

Impact of ambroxol hydrochloride adjuvant therapy on blood gas index and serum cytokines in AECOPD patients complicated with respiratory failure

目的探讨盐酸氨溴索辅助治疗对AECOPD合并呼吸衰竭患者血气指标及血清细胞因子的影响,旨在分析其治疗可能作用机制。方法选择2016年1月-2016年6月收治的AECOPD合并呼吸衰竭患者106例为研究对象,采用随机数字表法分为观察组和对照组各53例,对照组在常规治疗的基础上给予双水平无创正压通气治疗,观察组在对照组的基础上联合应用盐酸氨溴索辅助治疗,治疗2周后,比较两组血气指标、血清炎性因子、T淋巴细胞等。结果观察组pH值、动脉血氧分压(PO_2)、动脉血氧饱和度(SaO_2)明显高于对照组,动脉二氧化碳分压(PCO_2)明显低于对照组(t=2.118,P=0.032,t=15.133,P<0.001,t=10.398,P<0.001,t=9.285,P<0.001);血清白细胞介素-10(IL-10)明显高于对照组,白细胞介素-18(IL-18)、肿瘤坏死因子-α(TNF-α)明显低于对照组(t=11.321,P<0.001,t=5.610,P=0.011,t=8.742,P=0.002);CD4^+、CD4^+/CD8^+明显高于对照组,CD8^+明显低于对照组(t=9.011,P<0.001,t=7.687,P=0.005,t=6.616,P=0.008)。结论盐酸氨溴索辅助治疗有助于改善AECOPD合并呼吸衰竭患者血气指标,可能与抵制血清炎性因子表达、改善免疫功能有关。

Objective To study the effect of ambroxol hydrochloride adjuvant therapy on blood gas index and serum cytokines in AECOPD patients complicated with respiratory failure, and to analyze its potential mechanism.Methods 106 AECOPD patients complicated with respiratory failure from January 2016 to June 2016 were divided into the observation group and the control group. The control group was given bi-level positive airway pressure ventilation therapy on the basis of conventional treatment, and the observation group was additionally given ambroxol hydrochloride therapy. 2 weeks after therapy, their blood gas index, serum inflammatory cytokines, and T lymphocytes were compared between the two groups. Results The levels of pH, PO 2 and SaO 2 were significantly higher in the observation group than in the control group, and the level of PCO 2 was significantly lower in the observation group than in the control group ( t =2.118, P =0.032;t =15.133, P< 0.001;t =10.398, P< 0.001;t =9.285, P< 0.001). The level of serum IL-10 was significantly higher in the observation group than in the control group, and the levels of IL-18 and TNF-α were significantly lower in the observation group than in the control group ( t =11.321, P< 0.001;t =5.610, P =0.011;t =8.742, P =0.002). The value of CD4 + and CD4 +/CD8 + was significantly higher in the observation group than in the control group, and the value of CD8 + was significantly lower in the observation group than in the control group ( t =9.011, P< 0.001;t =7.687, P =0.005;t =6.616, P =0.008). Conclusion Ambroxol hydrochloride adjuvant therapy can help to improve blood gas index of AECOPD patients complicated with respiratory failure, which mechanism may be related to reduce serum inflammatory factor and improve immune function.