盐酸氨溴索对老年行非体外循环冠状动脉旁路移植术后肺泡表面活性物质的影响

摘要

Objective:To investigate the effect of ambroxol hydrochloride on pulmonary surfactant(PS)of elderly patients undergone off-pump coronary artery bypass grafting .Method:50 cases of patients(at the age of 65-75) were collected to line OPCABG,randomly divided into control group and treatment group(each of 25 cases). Patients in control group were treated with 0. 9%NaCl al one(10 mL ,iv,q8h,qdx3,preoperatively and postoperative),while those in treatment group received 30 mg ambroxol hydrochloride(iv,q8h,qdx3,preoperatively and postoperative). Right broncho-alreolar lavage(BAL)was carried out after intubation preoperatively ,postoperative and before removal of the cannula .Total phospholipid(TPL),saturated phosphaytidylcholine(SatPC)and total priotin(TP)in the BALF were measured.The ratio of SatPC/ TPL and SatPC/ TP represented the activity of PS. Result:Compared with preoperation,SatPC/TPL and SatPC/TP of two groups decreased at a certain extent postoperatively.The treatment group was better than the control group,there was statistical significance,preoperatively ,postoperative and before removal of the cannula. Conclusion:Ambroxol hydrochloride can promote the synthesis and secretion of PS in elderly patients undergone OPCABG,prevent the PS down,so as to improve the pulmonary function of patients after operation.%目的：研究盐酸氨溴索对老年非体外冠状动脉旁路移植（OPCABG）术后肺泡表面活性物质（PS）的影响。方法：选择50例65~75岁冠心病行OPCABG术者，随机分为对照组（25例）和治疗组（25例）。对照组给予生理盐水10 mL静推，每8小时一次，术前3 d开始应用，术后应用3 d；治疗组给予盐酸氨溴索30 mg静推，每8小时一次，术前3 d开始应用，术后应用3 d。气管插管后手术前、术后及拔除气管插管前，分别做右侧支气管肺泡灌洗，测定灌洗液中总磷脂（TPL）、饱和卵磷脂（SatPC）和总蛋白（TP）量。取SatPC/TPL和SatPC/TP比值作为判断PS活性水平的指标。结果：两组手术后SatPC/TPL和SatPC/TP值明显低于术前（P<0.05），拔管前基本恢复。治疗组术前、术后SatPC/TPL和SatPC/TP值明显高于对照组（P<0.05）。结论：盐酸氨溴索能促进老年OPCABG患者PS的合成和分泌，防止PS下降，从而改善术后患者肺功能。