山莨菪碱对肺癌开胸术后急性肺损伤的保护作用

摘要

目的:探讨山莨菪碱对肺癌术后急性肺损伤的保护作用.方法:选取2006年1月-2016年12月78例肺癌手术患者,分为治疗组40例,对照组38例.对照组不用山莨菪碱;治疗组:山莨菪碱每次1.0 mg/kg,8h静脉注射1次,共48 h.观察两组不同时间节点的炎性应激指标和肺功能变化,并作对比分析.结果:治疗24 h后,两组血清中肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、IL-10、超敏C反应蛋白(hs-CRP)及降钙素原(PCT)表达水平无统计学差异(P＞0.05);两组患者肺顺应性、动脉血氧分压(PaO2)和氧合指数亦无统计学差异(P＞0.05).治疗48 h后,治疗组TNF-α、IL-6、hs-CRP及PCT均低于对照组,而IL-10高于对照组(P＜0.05);治疗组患者肺顺应性、PaO2及氧合指数均高于对照组(P＜0.05).结论:山莨菪碱对肺癌开胸术后急性肺损伤的保护作用显著,可能通过调节TNF-α、IL-6、IL-10、hs-CRP及PCT表达水平发挥作用.%Objective:To study the protective effect of anisodamine on acute lung injury in patients with lung cancer underwent thoracotomy.Methods:Totally 78 patients with lung cancer underwent thoracotomy following acute lung injury were divided into treatment group(40 cases) and control group(38 cases).The treatment group was administered with anisodamine in the dose of 1.0 mg/kg every 8 h for 48 hours intravenously but the control without.Results:At postoperative 24 h, the serum level of TNF-α, IL-6, IL-10, hs-CRP and PCT was no significant difference between the two groups (P ＞ 0.05).The lung compliance, PaO2 and oxygenation index was no significant difference too(P ＞0.05).However, at postoperative 48 h,the lever of serum TNF-α, IL-6, hs-CRP and PCT in the treatment group was significant lower than that in control group(P ＜ 0.05).Interestingly IL-10 was significant higher than that of control(P ＜ 0.05).There was a significant difference in the quota of lung function between the two groups (P ＜ 0.05).Conclusion:Anisodamine plays a significant role of protect acute lung injury in patients undergoing thoracic surgery,possibly through regulation of TNF-α, IL-6,IL-10,hs-CRP and PCT expression.