氨溴索对循环紧闭全麻婴儿支气管肺泡灌洗液中PMN、TNF-α、IL-6及IL-8含量的影响  

Effect of Ambroxol on Contents of PMN,TNF-α,IL-6 and IL-8 in Bronchoalveolar Lavage Fluid after Closed Circuit Anesthesia in Infants

作　　者：沈晓署[1] 袁力勇[1] 甘果[1] 王霞民[1] 

机构地区：[1]浙江省宁波市妇女儿童医院麻醉科,315012

出　　处：《医学研究杂志》2008年第8期54-56,共3页Journal of Medical Research

基　　金：宁波市医学科技项目(2005538)

摘　　要：目的通过观察氨溴索对循环紧闭全麻婴儿支气管肺泡灌洗液中炎性物质含量的影响，探讨其减轻婴儿术后呼吸道不良反应的机制。方法择期ASAⅠ-Ⅱ级、行骨科及腹部手术患儿40例，随机分为氨溴索组（A组）和对照组（B组），每组20例。A组以0．3mg／kg氨溴索、B组以0．9％生理盐水10ml缓慢静脉注射。用药从术前2天开始，3次／天、于麻醉诱导前再给一次剂量。于气管插管后（T1）及全麻拔管前（T2）分别收集患儿的支气管肺泡灌洗液（BALF）。EASIA法、EIA法分别测定BALF中IL-6、IL-8及TNF-α含量，赖氏法染色进行PMN计数。比较两组患儿BALF中炎性物质含量、术后呼吸道不良反应。结果Tl时两组患儿BALF中PMN、TNF-α、IL-6、IL-8含量相似（P〉0．05）；T2时A组与B组相比，BALF中炎性物质减少（P〈0．05）；A组咳嗽发生率（29％）、气道分泌物量（25±11mL）分别低于B组（63％）、（67±19m1）（P〈0．05）。结论术前使用氨溴索可明显减轻气管插管循环紧闭全麻后婴儿呼吸道的不良反应，机制可能与氨溴索降低患儿BALF中炎性物质的含量有关。Objective To investigate the effect of ambroxol administered before surgery on contents of PMN,TNF-α,IL-6 and IL-8 in bronchoalveolar lavage fluid after closed circuit anesthesia in infants. Methods 40 infants who practiced selective orthopedics or abdominal operations were randomly divided into ambroxol group （group A） and control group （group B）. Two days before operation,in-fants in group A and group B were administed ambroxol 0.3 mg/kg or 0.9 % normal saline 10 ml through intravenous injection three times per day,respectively . The last single dose was administered before anesthesia induction. The bronchoalveolar lavage fluid of intants were collected immediately after tracheal intubation（ T1 ） and before tracheal extubation（ T2 ）, respectively. Interleukin -6 and interleukin -8 in the bronehoalveolar lavage fluid were determined by enhancement solid -phase enzyme immunoassay action（EASIA） ,and TNF- ct in the bronchoalveolar lavage fluid by euzymelinked immunosorbent assay （ EIA）. The numbers of polymorphonuclear neutrophils in the bron-choalveolar lavage fluid were examined. The contents of PMN,TNF-α,IL-6 and IL-8 in two groups were compared . The time of an-alepsia and complications of respiratory tract were observed after operation. Results Compared with group A, the contents of PMN,TNF-α, IL-6 and IL-8 in BALF collected at T2 were significant higher in group B （P〈0.05）. The incidences of cough and the quantity of secretion substance of airway in group B were higher than that in group A, respectively （P〈0.05）. Conclusion Ambroxol administered before surgery decrease the incidences of complications in respiratory tract after closed circuit anesthesia in infants, Which may be concerned with ambroxols decreas the release of inflammatory substances in BALF.

关 键 词：盐酸氨溴索 婴儿 循环紧闭全麻 支气管肺泡灌洗液 多形核中性白细胞 肿瘤坏死因子-α 白细胞介素-6 白细胞介素-8 

分 类 号：R562.25[医药卫生—呼吸系统] R725.622.5[医药卫生—内科学]