氨溴索对循环紧闭全麻婴儿支气管肺泡灌洗液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]宁波市妇女儿童医院,浙江宁波315012

出　　处：《现代实用医学》2008年第7期512-514,共3页Modern Practical Medicine

基　　金：江苏省自然科学基金资助项目;项目编号BK2001143;宁波市医学科技项目;项目编号2005538

摘　　要：目的探讨氨溴索对减轻婴儿术后呼吸道不良反应的机制。方法将ASAⅠ-Ⅱ级行骨科及腹部手术患儿随机分为氨溴索组（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2d开始,3次/d,于麻醉诱导前再给1次。于气管插管后（T1）及全麻拔管前（T2）收集患儿的支气管肺泡灌洗液（BALF）。用EASIA和EIA法分别测定BALF中IL-6、IL-8及TNF-α含量,用赖氏法染色进行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T1时两组患儿BALF中PMN、TNF-α、IL-6、IL-8含量相似（〉0.05）;T2时两组相比,A组BALF中炎性物质减少（〈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±19mL）（〈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 randomly divided into ambroxol group （group A） and control group （group B）. Two days beforeoperation,infants in group A and group B were administed ambroxol 0.3mg/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 （T 2 ）,respectively.Interleukin-6 and interleukin-8 in the bronchoalveolar lavage fluid were determined by enhancement solid-phase enzyme immunoassay action（EASIA）,TNF-α in the bronchoalveolar lavage fluid were determined by euzymelinked immunosorbent assay （EIA）.The numbers of polymorphonuclear neutrophils in the bronchoalveolar lavage fluid were examined.The contents of PMN,TNF-α ,IL-6 and IL-8 in two groups were compared.The time of analepsiaand 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 T 2 were significant higher in group B （ 〈 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（ 〈 0.05）. Conclusion Ambroxol administered before surgery beneficialtodecrease the incidencesofcomplicationsin respiratory tract after closed circuit anesthesia in infants.The mechanism may concerned with ambroxol could decrease the release of inflammatory substances in BALF .

关 键 词：氨溴索 婴儿 支气管肺泡灌洗液 肿瘤坏死因子 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]