盐酸氨溴索对急性呼吸窘迫综合征患者血清细胞因子浓度及动脉血气的影响

目的研究盐酸氨溴索对急性呼吸窘迫综合征（ARDS）患者血清IL-1β、IL-6、IL-8、IL-10、GM-CSF、TNF-α浓度及动脉血气的影响。方法选择ARDS患者40例，随机分成对照组（A组，n=20）和实验组（B组，n=20）。A组给予单纯生理盐水500ml静脉滴注，B组给予沐舒坦20mg／kg＋生理盐水500ml静脉滴注，共7d。比较两组患者治疗前、治疗第5d和治疗第7d血清细胞因子浓度及动脉血气方面的变化和差异。结果用药7dB组患者的血清IL-1β、IL-6、IL-8、GM-CSF，TNFα浓度明显降低，血清IL-10浓度显著升高（P〈0.05），血气指标明显改善（P〈0．05），与A组比较均有显著性差异（P〈0．05）。结论临床应用盐酸氨溴索可抑制ARDS患者促炎细胞因子的生成，而促进其抗炎细胞因子的产生，有利于其呼吸功能的恢复。

The Effect of Ambroxol On the Serum Cytokines of Patients with Acute Respicatory Distressed Syndrome(ARDS)

Objective To investigate the effect of Ambroxol on the serum IL-β3,IL-6, IL-8, TNF-α, GM-CSF and IL-10 and blood gas of patients with ARDS. Methods 40 patients with ARDS were enrolled in the study. They were randomly divided into 2 group. Patients in group A were treated only with 0.9% NaCl（500 ml）, in group B with Ambroxol（20 mg/kg） ＋0. 9% NaCl （500ml） for 7 consecutive days. The blood samples for blood gas and the serum IL-1β,IL-6,IL-8, TNF-α, GM-CSF and IL-10 measurements were taken before the first infusion ,5 day and 7 days following the first infusion respectively, Outcome of patients in both groups were analyzed. Results The blood gas indices of the patient in group B improved significantly （ P 〈 0. 05）, which were much better than those of group A （ P 〈 0. 05 ）. The serum IL-1β, IL-6, IL-8, TNF-α and GM-CSF of the patients in group B significantly declined （ P 〈 0. 05 ）, whereas IL-10 significantly increased comparing to the corresponding serum concentrations in group A after 7 days treatment respectively（ P 〈 0. 05 ）. Conclusion Ambroxol could inhibit the secretion of pro-inflammatory cytokines, but facilitate the secretion of anti-inflammatory cytokines of patient with ARDS. Pulmonary function of ARDS patients could benefit from clinical application of Ambroxol.