盐酸氨溴索对原位肝移植术后早期肺损伤的保护作用  

Protective Effect of Ambroxol Hydrochloride on Early Lung Injury After Orthotopic Liver Transplantation

作　　者：刘德昭[1] 李晓芸[1] Liu Dezhao Li Xiaoyun(Department of Anesthesiology, The Third Affiliated Hospital of SUN Yat - Sen University, Guangzhou, Guangdong, China 510630)

机构地区：[1]中山大学附属第三医院麻醉科,广东广州510630

出　　处：《中国药业》2017年第13期33-35,共3页China Pharmaceuticals

基　　金：广东省自然科学基金[2014A030313076];广东省医学科学基金[A2011190]

摘　　要：目的探讨盐酸氨溴索(沐舒坦)对原位肝移植围术期肺功能的保护作用。方法选择60例原位肝移植患者随机分为盐酸氨溴索组(A组)与对照组(C组),各30例。A组患者在麻醉前和新肝开放1 h后分别静脉泵注盐酸氨溴索150 mg(1 h内泵完),C组在麻醉后和新肝开放1 h后分别静脉泵注等量0.9%氯化钠注射液。分别比较两组肺功能指标(OI,RI)、呼吸力学指标(PIP,Pmean,Cdyn)、呼出气冷凝液中炎症介质(TNF-α,IL-1β,IL-6)水平和术后7 d不良反应、肺部感染、死亡的发生率。结果与C组比较,A组术毕和术后24 h的PIP,Pmean,RI明显降低,Cdyn,OI明显升高(P<0.05);呼出气冷凝液中TNF-α,IL-1β,IL-6水平均明显降低(P<0.05)。A组术后7 d内急性呼吸窘迫综合征和肺部感染发生率较C组明显降低(P<0.05);两组术后7 d内均无死亡病例。结论静脉输注盐酸氨溴索有助于改善原位肝移植围术期肺功能。Objective To investigate the protective effect of ambroxol hydrochloride on pulmonary function in patients undergoing orthotopic liver transplantation （ OLT ） . Methods A total of 60 OLT patients were randomly divided into the ambroxol hydrochloride （ group A ） and the control group （ group C ） , 30 cases in each group. Ambroxol hydrochloride was intravenous infused before anesthesia induction and 1 h after graft reperfusion in the group A. Meanwhile, the same volume of normal saline was administrated in group C. The lung function indexes （ OI, RI ） , respiratory mechanics indexes （ PIP, Pmean, Cdyn ） and inflammatory cytokines （ TNF-α, IL-1, and IL-6 ） in exhaled breath condensate （ EBC ） , the incidence of ARDS, lung infection and death in 1 weeks after operation were compared between the two groups. Results At the end of operation and 24 h after operation, compared with the group C, the PIP, Pmean and RI of the group A decreased significantly, and Cdyn and OI of the group A increased significantly （ P 〈 0. 05 ） , the levels of TNF-α IL-1β and IL-6 in EBC of the group A increased significantly （ P 〈 0. 05 ） . Within 7 d after operation, the incidence rates of ARDS and lung infection in group A were significantly lower than those in the group C （ P 〈 005 ） , and there were no deaths in the two groups within 7 days after opera tion . Conclusion Intravenous infusion of ambroxol hydrochloride can improve peroperative pulmonary function in patients undergoing OLT.

关 键 词：盐酸氨溴索 原位肝移植 肺保护 

分 类 号：R969.4[医药卫生—药理学] R974[医药卫生—药学]