纤维支气管镜下氨溴索肺泡灌洗对重症肺炎合并呼吸衰竭患者SIRS及靶器官功能损伤的影响  

Effect of fiberoptic bronchoscopic bronchoalveolar lavage with ambroxol on SIRS and target organ damage in patients with severe pneumonia complicated by respiratory failure

作　　者：邓小军[1] 杨丽萍[2] 

机构地区：[1]四川省自贡市第三人民医院呼吸科,四川自贡643020 [2]四川省自贡市第三人民医院药剂科,四川自贡643020

出　　处：《海南医学院学报》2017年第14期1889-1891,1895,共4页Journal of Hainan Medical University

基　　金：四川省教育厅资助项目(15zb028)~~

摘　　要：目的:探讨纤维支气管镜下氨溴索肺泡灌洗对重症肺炎合并呼吸衰竭患者全身炎症反应综合征(SIRS)及靶器官功能损伤的影响。方法:收集2013年7月~2016年12月在本院接受住院治疗的重症肺炎合并呼吸衰竭患者68例,回顾治疗方案并将入组患者分为接受常规治疗的对照组35例、接受纤维支气管镜下氨溴索肺泡灌洗+常规治疗的观察组33例,对比两组患者治疗前后全身炎症反应、心脏及肝脏功能的差异。结果:治疗前,两组患者血清中炎症因子、心肌酶谱、肝功能指标含量的差异无统计学意义(P>0.05)。治疗后,观察组血清中炎症因子白介素(IL)-6、IL-8、肿瘤坏死因子(TNF)-α、C反应蛋白(CRP)的含量低于对照组(P<0.05);血清中心肌酶谱乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)、肌酸磷酸激酶同工酶(CKMB)、肌钙蛋白Ⅰ(cTnⅠ)的含量低于对照组患者;血清中肝功能指标白蛋白(Alb)的含量高于对照组患者,碱性磷酸酶(ALP)、胆汁酸(TBA)、谷丙转氨酶(ALT)、谷草转氨酶(AST)含量低于对照组患者(P<0.05)。结论:纤维支气管镜下氨溴索肺泡灌洗可有效减轻重症肺炎合并呼吸衰竭患者的SIRS程度,同时减轻心脏及肝脏功能损伤。Objective：To study the effect of fiberoptic bronchoscopic bronchoalveolar lavage with ambroxol on the systemic inflammatory response syndrome（SIRS）and target organ damage in patients with severe pneumonia complicated by respiratory failure.Methods：A total of 68 patients with severe pneumonia complicated by respiratory failure who received inpatient treatment in our hospital between July 2013 and December 2016 were collected and then divided into control group（n=35）and observation group（n=33）.Patients in control group were treated by conventional therapy while those in observation group were treated by fiberoptic bronchoscopic bronchoalveolar lavage with ambroxol plus conventional therapy.The differences of the systemic inflammatory response as well as cardiac and liver function before and after treatment were compared between two groups of patients.Results：Before treatment,differences in serum levels of inflammatory factors,myocardial enzyme spectrum and liver function indexes of patients in two groups were not statistically significant（P〉0.05）.After treatment,serum inflammatory factors IL-6,IL-8,TNF-αand CRP levels in observation group were lower than those in control group;serum myocardial enzyme spectrum LDH,α-HBDH,CKMB and cTnⅠlevels were lower than those in control group;serum liver function index（Alb）content was higher than that in control group while ALP,TBA,ALT and AST contents were lower than those in control group（P〈0.05）.Conclusions：Fiberoptic bronchoscopic bronchoalveolar lavage with ambroxol can effectively reduce the degree of SIRS,and also decrease the cardiac and liver function injury in patients with severe pneumonia complicated by respiratory failure.

关 键 词：重症肺炎 呼吸衰竭 肺泡灌洗 炎症反应 

分 类 号：R563.1[医药卫生—呼吸系统] R563.8[医药卫生—内科学]