雾化吸入碳酸氢钠溶液对慢性阻塞性肺疾病急性加重患者呼出气冷凝液LTB4和TNF-α的影响  

Effect of the jet nebulised medication with sodium bicarbonate solution on LTB4 and TNF-α of the exhaled breath condensate in patients with AECOPD

作　　者：余春华[1] 李宏云[1] 秦超[1] 

机构地区：[1]郑州大学第五附属医院呼吸内科,河南郑州450052

出　　处：《中国医院药学杂志》2012年第16期1284-1287,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的:探讨雾化吸入碳酸氢钠液对慢性阻塞性肺疾病急性加重(AECOPD)患者呼出气冷凝液(EBC)白三烯B4(LTB4)和肿瘤坏死因子-α(TNF-α)的影响。方法:以2009年3月-2010年5月在郑州大学第五附属医院呼吸科住院的78例AECOPD患者为研究对象,随机分成临床组和对照组。对照组用抗感染、祛痰、常规雾化等治疗,临床组在对照组的基础上加雾化吸入碳酸氢钠液治疗,疗程均为1周,观察治疗前后EBC中pH值和LTB4及TNF-α的浓度变化以及肺功能的情况。结果:临床组治疗后pH(7.45±0.29)比治疗前明显升高(7.10±0.38,P<0.05),而对照组治疗后与治疗前差异无统计学意义(P>0.05);临床组和对照组患者治疗后的TNF-α分别为(15.3±10.2)ng.L-1和(26.4±14.4)ng.L-1,与治疗前(35.6±14.8)ng.L-1和(35.5±14.4)ng.L-1比较差异均有统计学意义(P均<0.05);临床组和对照组患者治疗后的LTB4分别为(14.6±11.2)ng.L-1和(20.2±12.2)ng.L-1,与治疗前(25.3±10.2)ng.L-1和(25.4±10.2)ng.L-1比较差异均有统计学意义(P均<0.05);但2组治疗前后差值的统计学比较,临床组差异更显著。临床组和对照组患者的1 s用力呼气量/用力肺活量、1 s用力呼气量%预计值在治疗前后的变化均有统计学意义(P均<0.05),相关分析显示,LTB4和TNF-α与肺功能等指标无相关性。结论:雾化吸入碳酸氢钠溶液可明显减轻AECOPD患者气道酸化的程度,降低其EBC中LTB4、TNF-α的浓度,提示雾化吸入碳酸氢钠溶液能有效缓解AECOPD患者炎症的严重程度。OBJECTIVE To explore the effect of the jet nebulised medication with sodium bicarbonate solution on leukotriene B4（LTB4） and tumor necrosis factor-a（TNF-a） of the exhaled breath condensate（EBC） in patients with AECOPD.METHODS 78 patients with AECOPD were enrolled.The patients were divided randomly into clinical group and control group.Control group treated with conventional anti-infection,eliminating phlegm and atomization,while clinical group added with atomization inhalation of sodium bicarbonate for one week.The changes of the lung function,TNF-α,LTB4 and pH value of EBC were measured by ELISA before and after treatment.RESULTS The pH value was higher after treatment in clinical group than that of control group,the difference of pH was statistical significance before and after treatment（7.10±0.38 vs 7.45±0.29,P0.05）.The concentrations of TNF-αin EBC of AECOPD after treatment（15.3±10.2）ng·L-1,（26.4±14.4）ng·L-1 were significantly lower than that of control group（35.65±14.76）ng·L-1、（35.46±14.43）ng·L-1,P0.05.The concentrations of LTB4 in EBC of AECOPD after treatment（14.6±11.2）ng·L-1,（20.2±12.2）ng·L-1 were significantly lower than that of control group（25.3±10.2）ng·L-1,（25.4±10.2）ng·L-1,P0.05.There was no statistical significance in the lung function（FEV1/FVC、FEV1%） before and after treatment either in the clinical group or in the control group（P0.05）.CONCLUSION These results suggest that atomization inhalation of sodium bicarbonate solution can decrease the acidifying degree of the airway and lower the TNF-α and LTB4 of the EBC in patients of AECOPD.

关 键 词：碳酸氢钠溶液 慢性阻塞性肺疾病 呼出气冷凝液 白三烯B4 肿瘤坏死因子-α 

分 类 号：R969[医药卫生—药理学]