雾化吸入小剂量氨溴索对开胸食道手术患者单肺通气时炎性反应的影响  

Effects of inhaled aerosolized low dose ambroxol on inflammatory response to one-lung ventilation in patients undergoing open-chest esophagus surgery

作　　者：李明川[1] 李毅海[1] 丁素春[1] 李爱芝[1] 姜秀良[1] 

机构地区：[1]青岛大学医学院附属烟台毓璜顶医院,264000

出　　处：《中华麻醉学杂志》2011年第4期401-403,共3页Chinese Journal of Anesthesiology

基　　金：烟台市科技发展计划项目（2008142-7）

摘　　要：目的评价雾化吸入氨溴索对开胸食道手术患者单肺通气时炎性反应的影响。方法择期行开胸食道手术患者60例，ASA分级I或Ⅱ级，年龄39—64岁，体重50—85奴，身高153～181cm。采用随机数字表法，将患者随机分为3组（n=20）：对照组（c组）、静脉输注氨溴索组（IA组）和雾化吸入氨溴索组（AIA组）。单肺通气前10min，C组静脉输注生理盐水250mL；IA组静脉输注氨溴索10mg／kg（用生理盐水稀释至250m1）；AIA组采用自制装置氧气驱动雾化吸人氨溴索4ml（30mg）＋生理盐水2ml，氧流量5～6L／mim。于麻醉诱导后给药前1min（To）、单肺通气90min（T1）和恢复双肺通气30min（T2）时，采集桡动脉血样，采用双抗体夹心ELISA法测定血清TNF-α、IL-1β、IL-8和IL-10的浓度。结果与T0时比较，各组，T1和T2时血清TNF-α、IL-1β、IL-8的浓度升高，IL-10浓度降低（P〈0．05）；与C组比较，IA组和AIA组T1和T2时血清TNF-α、IL-1β、IL-8的浓度降低，IL-10浓度升高（P〈0．05）；IA组和AIA组各时点血清TNF-α、IL-1β、IL-8、IL-10的浓度差异无统计学意义（P〉0．05）。结论雾化吸人小剂量氨溴索可抑制开胸食道手术患者单肺通气导致的炎性反应，且与静脉注射大剂量氨溴索效果相似。Objective To investigate the effects of inhaled aerosolized low dose ambroxol on the inflammatory response to one-lung ventilation （OLV） in patients undergoing open-chest esophagus surgery. Methods Sixty patients with normal heart and lung function undergoing open-chest esophagus surgery were randomly divided into 3 groups （ n = 20 each） ： control group （group C） ; group IA received IV ambroxol 10 mg/kg after induction of anesthesia and group AIA inhaled aerosolized ambroxol 30 mg after induction of anesthesia. Arterial blood samples were taken after induction of anesthesia before ambroxol administration （To, baseline）, at 90 min of OLV （T1） and at 30 min after OLV （T2 ） for determination of plasma concentrations of TNF-α、IL-1β, IL-8 and IL-10 by ELISA.Results Plasma TNF-α、IL-1β, and IL-8 concentrations were significantly increased while plasma IL-10 concentration was significantly decreased at TI and T2 as compared with the baseline at To in all 3 groups. Plasma TNF-α、IL-1β, and IL-8 concentrations were significantly lower and plasma IL-10 concentration was significantly higher at Tl and T2 in groups IA and AIA than in group C. Conclusion Both IV large dose ambroxol and inhaled aerosolized low dose ambrexol can inhibit the inflammatory response to OLV in patients undergoing open-chest esophagus surgery.

关 键 词：氨溴索 呼吸疗法 呼吸 人工 炎症 

分 类 号：R614[医药卫生—麻醉学]