氨溴索联合吸入用复方异丙托溴铵溶液对早期气管切开重型颅脑损伤患者通气功能及IFN-γ、HIF-1α水平的影响

Effects of ambroxol combined with compound ipratropium bromide solution for inhalation on ventilation function and IFN-γ, HIF-1α levels in patients with severe traumatic brain injury undergoing early tracheotomy

目的 探讨氨溴索联合吸入用复方异丙托溴铵溶液对早期气管切开重型颅脑损伤(sTBI)患者通气功能及干扰素-γ(IFN-γ)、缺氧诱导因子-1α(HIF-1α)水平的影响。方法 选择2019年2月至2020年11月我院接收的80例早期气管切开sTBI患者作为研究对象,根据治疗方案将其分为对照组和观察组,每组40例。对照组给予吸入用复方异丙托溴铵溶液治疗,观察组在对照组的基础上联合氨溴索治疗。比较两组的治疗效果。结果 治疗前,两组的动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数(OI)比较,差异无统计学意义(P>0.05);治疗后,观察组的PaO_(2)、SaO_(2)、OI高于对照组,PaCO_(2)低于对照组,差异具有统计学意义(P<0.05)。治疗前,两组的IFN-γ、HIF-1α水平比较,差异无统计学意义(P>0.05);治疗后,观察组的IFN-γ水平高于对照组,HIF-1α水平低于对照组,差异具有统计学意义(P<0.05)。观察组的不良反应总发生率为7.50%,明显低于对照组的25.00%,差异具有统计学意义(P<0.05)。治疗前,两组的白三烯B4(LTB4)、降钙素原(PCT)、超氧化物歧化酶(SOD)水平比较,差异无统计学意义(P>0.05);治疗后,观察组的LTB4、PCT水平低于对照组,SOD水平高于对照组,差异具有统计学意义(P<0.05)。结论 氨溴索联合吸入用复方异丙托溴铵溶液应用于早期气管切开sTBI患者中,可有效改善通气功能,调节IFN-γ、HIF-1α水平,降低不良反应发生率,值得推广。

Objective To explore the effect of ambroxol combined with compound ipratropium bromide solution for inhalation on ventilation function and interferon-γ(IFN-γ), hypoxia-inducible factor-1(HIF-1α) levels in patients with severe traumatic brain injury(sTBI) undergoing early tracheotomy. Methods Eighty patients with sTBI who received early tracheotomy in our hospital from February 2019 to November 2020 were selected as the research objects and divided into control group and observation group according to treatment plan, with 40 cases in each group. The control group was treated with compound ipratropium bromide solution for inhalation, and the observation group was treated with ambroxol on the basis of the control group. The therapeutic effects of the two groups were compared. Results Before treatment, there were no significant differences in arterial partial pressure of oxygen(PaO_(2)), arterial oxygen saturation(SaO_(2)), arterial partial pressure of carbon dioxide(PaCO_(2)) and oxygenation index(OI) between the two groups(P>0.05);after treatment, the PaO_(2),SaO_(2) and OI of the observation group were higher than those of the control group, the PaCO_(2) was lower than that of the control group, and the differences were statistically significant(P <0.05). Before treatment, there were no significant differences in IFN-γ and HIF-1α levels between the two groups(P >0.05);after treatment, the IFN-γ level in the observation group was higher than that in the control group, the HIF-1α level was lower than that in the control group, and the differences were statistically significant(P<0.05). The total incidence of adverse reactions in the observation group was7.50%, which was significantly lower than 25.00% in the control group, and the difference was statistically significant(P<0.05).Before treatment, there were no significant differences in leukotriene B4(LTB4), procalcitonin(PCT) and superoxide dismutase(SOD) levels between the two groups(P>0.05);after treatment, the LTB4 and PCT levels of the observation group were lower than those of the control group, the SOD level was higher than that of the control group, and the differences were statistically significant(P<0.05). Conclusion The ambroxol combined with compound ipraporonium bromide solution for inhalation applied in sTBI patients undergoing early tracheotomy can effectively improve the ventilation function,regulate the IFN-γ and HIF-1α levels, and reduce the incidence of adverse reactions, which is worthy of promotion.