不同剂量沐舒坦对老年慢性阻塞性肺疾病急性加重期痰液中炎性细胞因子的影响

目的：观察不同剂量沐舒坦对老年慢性阻塞性肺疾病急性加重期（ AECOPD ）痰液中炎性细胞因子（ IL-6、IL-8、TNF-α）的影响，旨在寻找最佳治疗效果的最小沐舒坦剂量。方法选择老年AECOPD患者194例，随机分成4组，每组50例。其中，A、B、C组分别给予沐舒坦30、90、330 mg/次，D组给予若通4 mg/次，3次/d，连续静滴7 d。分别观察各组入院第1、4、7天痰液中IL-6、IL-8、TNF-α水平的变化。结果与A、B、D组比较，C组于入院第4天和第7天痰液中IL-6、IL-8、TNF-α下降最明显（P均＜0．05）；A、B、D组入院第4天与入院第7天，痰液中IL-6、IL-8、TNF-α变化不明显（P均＞0．05）。结论短期大剂量应用沐舒坦能显著降低老年AECOPD患者痰液中IL-6、IL-8、TNF-α水平，具有良好的抗炎作用。

Effects of different doses of ambroxol on cytokines in sputum from elderly patients with AECOPD

Objective To observe the effects of different doses of ambroxol on cytokines （ IL-6, IL-8 and TNF-α） in the sputum from elderly patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）, and to find the minimum dose of ambroxol with the best treatment effect .Methods Totally 194 cases of elderly patients with AECOPD were selected and were randomly divided into four groups , 50 cases in each group：groups A, B, C and D.Patients in the groups A, B and C were given 30, 90 and 330 mg/sub ambroxol;patients in the group D were treated with bromhexine 4 mg/sub, three times a day;and all patients were continuously treated with intravenous infusion for seven days .The chan-ges of IL-6, IL-8 and TNF-α in each group on the first day , the forth day and the seventh day of hospitalization were observed.Results Compared with groups A , B and D, IL-6、IL-8 and TNF-α on the forth day and the seventh day in the group C had the greatest reduction （all P〈0.05）, but there were no significant differences between the forth day and the seventh day（all P〉0.05）.Conclusion Short-term and high-dose of ambroxol in treatment of elderly AECOPD has not only good expectorant effect but also reduces the airway inflammation of AECOPD patients , and it shows a dose-dependent manner .