氨溴索治疗高原地区慢性肺心病急性加重期抗氧化作用的研究

目的探讨氨溴索治疗高原慢性肺心病急性加重期的抗氧化作用。方法高原慢性肺心病急性加重期患者80例,随机分为两组,每组40例。氨溴索治疗组(A组):氨溴索注射液30mg静脉滴注,2次.d-1;常规治疗组(B组):仅常规治疗。在治疗前和治疗后4周,分别测血清8-isoPGF2α、IL-4、1秒钟用力呼气容积(FEV1)占预计值的百分比(FEV1%)、FEV1/用力肺活量(FVC)比值(FEV1/FVC)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)。并以40例当地健康人作为对照组(C组)。结果A、B组治疗前血清8-isoPGF2α、IL-4、PaCO2水平显著高于C组(P均0.01),FEV1%、FEV1/FVC、PaO2显著低于C组(P均0.01),A、B组之间差异无显著性(P均0.05)。A、B组血清8-isoPGF2α、IL-4与FEV1%、FEV1/FVC、PaO2均呈显著负相关(P均0.01),与PaCO2呈显著正相关(P均0.01)。治疗后,A、B组血清8-isoPGF2α、IL-4、FEV1%、FEV1/FVC、PaO2和PaCO2均较治疗前显著改善(P0.01或P0.05),但A组较B组改善更显著,两组比较P均0.01。结论高原肺心病急性加重期患者血清8-isoPGF2α、IL-4水平显著升高,且其升高与肺功能损害和血气恶化程度密切相关;抗氧化剂氨溴索在高原肺心病急性加重期具有较好的抗氧化治疗作用。

The effect of ambroxol in treating patients with acute exacerbation of chronic cor pulmonale in high altitude area

Objective To assess the relationship between change of serum 8-iso prostaglandin（PG） F2a （8-iso PGF2a ） ,interleukin-4（IL-4） and incidence of chronic cor pulmonale in high altitude area（HAECCP） and to study the effect of ambroxol in treating patients with acute exacerbation of HACCP. Methods 80 patients with acute exacerbation of HACCP were randomly divided into 2 groups with 40 eases in each, a ambroxol therapy group （ group A ） （ combination routine and ambroxol, ambroxol 30 mg was infused intravenously, two times daily ） and a routine therapy group （ group B ） （ only routine treatment）. Level of serum 8-iso PGF2a, IL-4, forced expiratory volume in 1 second （FEV1）, expressed as percentage predicted （FEVt % ）, ratio of FEV1 to forced vital capacity （FEV~/FVC ）, partial pressure of arterial O2 （ PaO2 ） and partial pressure of arterial CO2 （ PaCO2 ） were measured before and 4 weeks after the treatment. Another, the upper mentioned parameters were measured in 40 healthy peoples（ group C ）. Results Level of serum 8-iso PGF2a, IL-4 and PaCO2 in group A and group B were signigcantly higher than those in group C （ all P 〈 0. 01 ）, FEV1% , FEV1/FVC, PaO2 in group A and group B were significantly lower than those in group C （ all P 〈 0. 01 ） , there were no differences between the group A and group B （ all P 〉 0. 05 ）. Level of serum 8-iso PGF2a, IL-4 in group A and group B was negatively correlated with FEV1 % , FEV1/FVC, PaO2 （all P 〈 0. 01 ）, positively correlated with PaCO2 （ all P 〈 0. 01 ）. The after therapy, serum 8-iso PGFz , IL-4, FEV1% , FEV1/FVC, PaO2 and PaCO2 in group A and group B were all markedly improved compared with those before the treatment（ P 〈 0.01 or P 〈 0. 05 ）, those parameters in group A were markedly improved compared with those in group B （ all P 〈 0. 01 ）. Condusion The level of serum 8-iso PGF2a, IL-4 in patients with acute exacerbation of HACCP were significantly increased, and the increased 8-iso PGF2a and IL-4 may be correlated with the deterioration of lung function. Ambroxol has better effects of antioxidation in patients with acute exacerbation of HACCP.