盐酸氨溴索结合无创正压通气对急性呼吸窘迫综合征患者肺循环功能及氧化应激状态的影响

Effect of ambroxol hydrochloride combined with noninvasive positive pressure ventilation on pulmonary circulation function and oxidative stress state in patients with acute respiratory distress syndrome

目的:研究盐酸氨溴索结合无创正压通气(NIPPV)对急性呼吸窘迫综合征(ARDS)患者肺循环功能及氧化应激状态的影响。方法:2016年1月-2018年12月收治ARDS患者60例,按不同治疗方案分为两组,各30例。对照组接受NIPPV治疗方案;观察组在NIPPV基础上接受盐酸氨溴索治疗方案。比较两组肺循环功能指标水平、氧化应激指标水平及血清细胞因子浓度。结果:观察组治疗后动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))及氧和指数(PaO_(2)/FiO_(2))等指标水平均高于对照组,差异有统计学意义(P<0.05);观察组治疗后超氧化物歧化酶(SOD)、谷胱甘肽(GSH)及总氧化能力(TAO)等指标水平均高于对照组,丙二醛(MDA)水平低于对照组,差异有统计学意义(P<0.05);观察组治疗后肿瘤坏死因子α(TNF-α)、白介素-6(IL-6)及白介素-10(IL-10)等指标水平均优于对照组,差异有统计学意义(P<0.05)。结论:盐酸氨溴索结合NIPPV治疗ARDS,效果尤为显著,能够有效提高患者肺部循环功能,抑制机体炎性反应,改善氧化应激状态。

Objective:To explore the effect of ambroxol hydrochloride combined with noninvasive positive pressure ventilation on pulmonary circulation function and oxidative stress state in patients with acute respiratory distress syndrome.Methods:From January 2016 to December 2018,60 patients with ARDS were selected and divided into two groups according to different treatment schemes with 30 cases in each group.The control group received NIPPV treatment.The observation group received ambroxol hydrochloride treatment on the basis of NIPPV.We compared the levels of pulmonary circulation function,oxidative stress and serum cytokines between the two groups.Results:After treatment,arterial partial pressure of oxygen(PaO_(2)),arterial saturation of oxygen(SaO_(2))and oxygen index(PaO_(2)/FiO_(2))in the observation group were higher than those in the control group,the difference was statistically significant(P<0.05).In the observation group,after treatment,the levels of superoxide dismutase(SOD),glutathione(GSH)and total oxidation capacity(TAO)were higher than those in the control group,and the level of malondialdehyde(MDA)was lower than that in the control group,the difference was statistically significant(P<0.05).In the observation group,after treatment,the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-10(IL-10)were better than those in the control group,the difference was statistically significant(P<0.05).Conclusion:Ambroxol hydrochloride combined with NIPPV is particularly effective in the treatment of ARDS,it can effectively improve pulmonary circulation function,inhibit inflammatory reaction and improve oxidative stress.