氨溴索联合纳洛酮对老年呼吸衰竭伴肺部感染患者IL-6/STAT3、氧化应激及血管内皮的影响

Effects of ambroxol combined with naloxone on the IL-6/STAT3 inflammatory signaling pathway,oxidative stress and vascular endothelial function in elderly patients with respiratory failure and pulmonary infection

目的研究氨溴索联合纳洛酮对老年呼吸衰竭伴肺部感染患者IL-6/STAT3炎症信号通路、氧化应激、血管内皮功能的影响。方法选取2022年1~10月老年呼吸衰竭伴肺部感染患者120例,随机数字表法分为观察组和对照组,每组60例。入院后均采取常规治疗,于此基础上对照组采取纳洛酮治疗,观察组采取氨溴索联合纳洛酮治疗,比较2组肺功能[力肺活量(FVC)、第1秒用力呼气容积占预计值百分比(FEV1%)、1 s用力呼气容积(FEV1)]、血气指标[血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、酸碱度(pH)]、氧化应激[超氧化物歧化酶(SOD)、丙二醛(MDA)、8-异前列腺素F2α(8-iso-F2α)]、血管内皮[一氧化氮(NO)、内皮素-1(ET-1)、可溶性细胞间黏附分子(Sicam-1)]、炎症相关指标[白细胞介素6(IL-6)、信号转导与转录激活因子3(STAT3)、白细胞介素-1β(IL-1β)]及安全性分析。结果治疗7 d后,观察组FVC、FEV1、FEV1%PaO_(2)、PH水平均高于对照组,PaCO_(2)低于对照组(P<0.05);治疗3 d、7 d后,观察组SOD、NO水平高于对照组,MDA、8-iso-F2α、ET-1、Sicam-1水平低于对照组(P<0.05);治疗3 d、7 d后,观察组IL-6、STAT3、IL-1β等相关炎症指标低于对照组(P<0.05);2组不良反应发生率比较差异无统计学意义(P>0.05)。结论在老年呼吸衰竭伴肺部感染患者治疗中,氨溴索联合纳洛酮可通过IL-6/STAT3炎症信号通路产生抗炎作用,并在减轻氧化应激、改善血管内皮功能和肺功能方面效果显著,疗效确切。

Objective To observe the application of ambroxol combined with naloxone on the interleukin-6(IL-6)/signal transducers and activators of transcription 3(STAT3)inflammatory signaling pathway,oxidative stress and vascular endothelial function in elderly patients with respiratory failure and pulmonary infection.Methods A total of 120 elderly patients with respiratory failure and pulmonary infection visited our hospital from January 2022 to October 2022 were selected.They were randomly divided into the observation group(n=60)and control group(n=60).The patients of the control group received conventional treatment and naloxone medication,and those of the observation group were additionally given ambroxol.Pulmonary function(forced vital capacity[FVC],forced expiratory volume in 1 second[FEV1],FEV1 as percent of predicted[FEV1%]),blood gas indicators(partial pressure of oxygen[PaO_(2)],partial pressure of carbon dioxide[PaCO_(2)],pH),oxidative stress(superoxide dismutase[SOD],malondialdehyde[MDA],8-isoprostane F2α[8-iso-F2α]),vascular endothelium(nitric oxide[NO],endothelin-1[ET-1],soluble intercellular adhesion molecule-1[sICAM-1]),inflammatory factors(interleukin-6[IL-6],signal transducers and activators of transcription 3[STAT3],interleukin-1β[IL-1β])and safety were compared between groups.Results After 7 days of treatment,the levels of FVC,FEV1,FEV1%,PaO_(2) and PH in the observation group were significantly higher than those in the control group(P<0.05),while the level of PaCO_(2) was significantly lower(P<0.05).After 3 days and 7 days of treatment,the levels of SOD and NO in the observation group was significantly higher than those in the control group,and the levels of MDA,8-iso-F2α,ET-1 and sICAM-1 were significantly lower than those in the control group(P<0.05).After 3 days and 7 days of treatment,the levels of IL-6,STAT3,IL-1βand other inflammatory factors in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse events between groups(P>0.05).Conclusion For elderly patients with respiratory failure and lung infection,ambroxol combined with naloxone can produce anti-inflammatory effects through the IL-6/STAT3 inflammatory signaling pathway,which has significant effects on reducing oxidative stress,improving vascular endothelial function and lung function.