氨溴索对机械通气患者呼吸力学及氧化应激的影响

目的 研究氨溴索针剂对慢性阻塞性肺疾病(COPD)并呼吸衰竭患者机械通气过程中呼吸力学及氧化应激的影响。方法 COPD并呼吸衰竭的机械通气患者，在机械通气过程中分别采用氨溴索针剂和必漱平针剂治疗，监测气道峰压(PIP)、平台压(Pplat)、平均气道压(Pm)、内源性呼气末正压(PEEPi)、静态顺应性(Cs)、动态顺应性(Cd)和吸气阻力(Ri)变化，并检测了血清丙二醛(MDA)、谷胱甘肽(GSH)含量，超氧化物歧化酶活性(SOD)及总抗氧化能力(TAO)水平。结果 氨溴索治疗显著降低患者Ri、PIP、Pplat、Pm、PEEPi水平，显著增高Cs、Cd水平，并使血清MDA含量显著降低，SOD、GSH及TAO水平显著提高。结论 氨溴索治疗对COPD并呼吸衰竭的机械通气患者呼吸力学状态具有明显改善作用，并能减轻患者氧化应激水平，对呼吸机相关性肺损伤具有保护作用。

Effect of Ambroxol on pneumodynamics and oxidative stress in the patients with COPD during mechanical ventilation

Objective To investigate the effect of Ambroxol on pneumodynamics and oxidative stress in the patients with chronic obstructive pulmonary disease(COPD) and respiratory failure during mechanical ventilation.Methods Patients with COPD were treated with Ambroxol during mechanical ventilation.The parameter of pneumodynamics(Ri,PIP,Pplat,Pm,PEEPi,Cs,Cd)were monitored.The level of serum MDA,SOD,GSH and TAO were determined.Results After the application of Ambroxol,the level of Ri,PIP,Pplat,Pm,PEEPi decreased significantly,and the level of Cs,Cd increased significantly.Meanwhile,MDA content decreased significantly,and the level of GSH,SOD and TAO increased significantly.Conclusion Ambroxol treatment could improve obviously the status of pneumodynamics and ameliorate the oxidative stress in the patients with COPD during mechanical ventilation.As a result,the lung injury relative to ventilation would be prevented.