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目的探讨氨溴索对小儿心肺转流(CPB)术后炎症介质和呼吸功能的影响。方法31例CPB下行室间隔缺损修补术患儿随机分为氨溴索(A)组(n=15)和对照(C)组(n=16)。A组术前3d及术后2d静脉滴注氨溴索20mg.kg-1.d-1并行雾化吸入;C组使用等量生理盐水。分别在CPB前(T1),CPB结束(T2)和CPB结束后2h(T3)、4h(T4)及18h(T5)采集桡动脉血,测定血浆IL-6、IL-8、TNF-α浓度,计算呼吸指数(RI)和氧合指数(OI)。结果 T2-T5时点,两组血浆IL-6、IL-8和TNF-α浓度均较T1时增加,C组高于A组(P<0.05)。CPB后两组RI和OI均较CPB前升高,C组高于A组(P<0.05)。结论氨溴索能够通过抑制炎症因子的产生减轻小儿CPB引起的肺损伤和功能障碍。
Objective To investigate the effect of ambroxol on inflammatory mediators and respiratory function after cardiopulmonary bypass (CPB) in children. Methods Thirty-one children undergoing CPB descending ventricular septal defect repair were randomly divided into ambroxol group (n = 15) and control group (n = 16). A group of preoperative 3d and 2d after intravenous infusion of ambroxol 20mg.kg-1.d-1 parallel inhalation; C group using the same amount of saline. Radial artery blood was collected before CPB (T1), end of CPB (T2) and 2h (T3), 4h (T4) and 18h (T5) after CPB. Plasma concentrations of IL-6, IL-8 and TNF- , Respiratory index (RI) and oxygenation index (OI) were calculated. Results At T2-T5, the levels of IL-6, IL-8 and TNF-α in plasma increased in both groups compared with those in T1 and C groups (P <0.05). The RI and OI of the two groups after CPB were higher than those before CPB, while those in group C were higher than those of group A (P <0.05). Conclusion Ambroxol can alleviate CPB-induced lung injury and dysfunction in children by inhibiting the production of inflammatory cytokines.