盐酸氨溴索对体外循环患儿术后肾功能的影响  

Effects of ambroxol on renal function in children undergoing cardiopulmonary bypass

作　　者：刘建华[1] 谢才姣[1] 李李[1] 

机构地区：[1]中南大学湘雅二医院麻醉科,湖南长沙410011

出　　处：《中国当代儿科杂志》2009年第8期656-658,共3页Chinese Journal of Contemporary Pediatrics

摘　　要：目的有研究表明盐酸氨溴索可减轻体外循环所致的肺损伤,但其对体外循环患者术后肾功能损害的作用尚不十分清楚。该研究拟探讨盐酸氨溴索对体外循环下室间隔缺损修补术患儿肾功能的影响,为临床应用提供参考。方法选择在体外循环下择期行室间隔缺损修补术患儿40例,年龄3～8岁,心功能I或II级,随机分为对照组和盐酸氨溴索组,每组20例。盐酸氨溴索组切皮后缓慢静脉注射4.5mg/kg盐酸氨溴索(生理盐水稀释至10mL),对照组静脉输注等容量生理盐水。分别于术前、术后2h、12h、24h及48h取静脉血及新鲜尿液,检测尿中视黄醇结合蛋白(RBP)、N-乙酰-β-D-氨基葡萄糖酐酶(NAG)、β2-微球蛋白(β2-MG)水平及血清β2-MG、肌酐(Cr)、尿素氮(BUN)浓度。结果与术前相比,两组术后2h血清Cr、尿β2-MG,术后2h及12h血清β2-MG,术后2h,12h,24h,48h尿RBP,及术后2h,12h,24h尿NAG水平升高(P<0.05)。氨溴索组术后2h时血清Cr,术后2h及12h血清β2-MG、尿β2-MG,术后2h,12h,24h,48h尿RBP,以及术后12h和24h尿NAG的水平明显低于对照组(P<0.05)。结论盐酸氨溴索可减轻体外循环所致患儿的肾损伤,其作用机制有待进一步研究。Objective Some research has shown that ambroxol can alleviate lung injury induced by cardiopulmonary bypass（CPB）.However,whether ambroxol has protective effects against CPB-induced renal injury remains unknown.This study investigated the effect of ambroxol on renal function in children undergoing CPB.Methods Forty children at ages of 3-8 years with cardiac function classⅠor Ⅱand weighing 12-25 kg,underwent repair of ventricular septal defect（VSD）under CPB.They were randomly divided into two groups（n=20 each）：control and ambroxol-treated.The children in the ambroxol-treated group received ambroxol of 4.5 mg/kg in 10 mL normal saline by intravenous injection after skin incision.The control group received 10 mL of normal saline instead.Serum concentrations of urea nitrogen（BUN）,β2-microglobulin（β2-MG）and creatinine（Cr）and urinary β2-MG,retinol-binding-protein（RBP）and N-acetyl-β-D-glucosaminidase（NAG）were measured before operation,and 2,12,24 and 48 hrs after operation.Results Serum Cr and urinary β2-MG concentrations 2 hrs after operation,serum β2-MG concentration 2 and 12 hrs after operation,urinary RBP concentration 2,12,24 and 48 hrs after operation,and urinary NAG concentration 2,12 and 24 hrs after operation in the control and the ambroxol-treated groups increased significantly as compared with their baseline values（before operation）（P〈0.05）.Serum Cr concentration 2 hrs after operation,serum β2-MG and urinary β2-MG concentrations 2 and 12 hrs after operation,urinary RBP concentration 2,12,24 and 48 hrs after operation,and urinary NAG concentration 12 and 24 hrs after operation in the ambroxol-treated group were significantly lower than those in the control group（P〈0.05）.Conclusions Ambroxol administration before CPB is effective in reducing CPB-induced renal injury in children undergoing repair of VSD.Further research is required to understand the mechanism.

关 键 词：盐酸氨溴索 体外循环 肾功能试验 儿童 

分 类 号：R726.5[医药卫生—儿科]