CAJ | 학술논문

目的评价氨溴索预先给药对单肺通气患者炎性反应及脂质过氧化反应的影响.方法选择开胸手术患者45例,年龄37～64岁,体重53～65 kg,ASAⅠ或Ⅱ级,随机分为3组(n=15),双肺通气组(TLV组)、单肺通气组(OLV组),单肺通气+氨溴索组(OLV+AMB组)于单肺通气前25 min开始静脉输注氨溴索1 mg/kg(100 ml,4 ml/min),TLV组和OLV组静脉输注等容量生理盐水.OLV组和OLV+AMB组于麻醉诱导前(T0)、单肺通气前即刻(T1)、单肺通气0.5 h(T2)、1 h(T3)、2 h(T4)、恢复双肺通气后1 h(T5)、2 h(T6)和术后24 h(T7)时,TLV组于上述对应时点,采集桡动脉血样,测定血清TNF-α、IL-6、IL-8浓度和SOD活性,进行WBC和中性粒细胞(PMN)计数.结果与TLV组比较,OLV组血清IL-6、IL-8、TNF-α浓度升高,SOD活性降低,WBC和PMN计数升高(P<0.05或0.01);与OLV组比较,OLV+AMB组血清IL-6、IL-8和TNF-α浓度降低,SOD活性升高,WBC和PMN计数降低(P<0.05或0.01).结论氨溴索1 mg/kg预先给药可减轻单肺通气患者炎性反应及脂质过氧化反应.
목적 평개안추색예선급약대단폐통기환자염성반응급지질과양화반응적영향.방법 선택개흉수술환자45례,년령37～64세,체중53～65 kg,ASAⅠ혹Ⅱ급,수궤분위3조(n=15),쌍폐통기조(TLV조)、단폐통기조(OLV조),단폐통기+안추색조(OLV+AMB조)우단폐통기전25 min개시정맥수주안추색1 mg/kg(100 ml,4 ml/min),TLV조화OLV조정맥수주등용량생리염수.OLV조화OLV+AMB조우마취유도전(T0)、단폐통기전즉각(T1)、단폐통기0.5 h(T2)、1 h(T3)、2 h(T4)、회복쌍폐통기후1 h(T5)、2 h(T6)화술후24 h(T7)시,TLV조우상술대응시점,채집뇨동맥혈양,측정혈청TNF-α、IL-6、IL-8농도화SOD활성,진행WBC화중성립세포(PMN)계수.결과 여TLV조비교,OLV조혈청IL-6、IL-8、TNF-α농도승고,SOD활성강저,WBC화PMN계수승고(P<0.05혹0.01);여OLV조비교,OLV+AMB조혈청IL-6、IL-8화TNF-α농도강저,SOD활성승고,WBC화PMN계수강저(P<0.05혹0.01).결론 안추색1 mg/kg예선급약가감경단폐통기환자염성반응급지질과양화반응.
Objective To investigate the effect of ambroxol pretreatment on the inflammatory response and lipid peroxidation during one-lung ventilation (OLV) .Methods Forty-five ASA I or II patients aged 37-64 yr weighing 53-65 kg undergoing thoracotomy under general anesthesia were randomly divided into 3 groups ( n = 15 each): group A two-lung ventilation (TLV); group B OLV and group C ambroxol 1 mg/kg + OLV. Anesthesia was induced with midazolam, fentanyl, propofol and atracurium and maintained with propofol infusion and intermittent iv boluses of fentanyl and atracurium. The patients were mechanically ventilated (VT8-10 ml/kg, RR 12 bpm during TLV, VT 6-7 ml/kg, RR 16 bpm during OLV, I: E 1:2, FiO2 100% ). In group C ambroxol 1 mg/kg in normal saline ( NS) 100 ml was infused at 25 min before OLV (infusion rate 4 ml/min) , while in group A and B equal volume of NS was infused instead of ambroxol. Blood samples were obtained from radial artery before induction of anesthesia and OLV (T0.1 ) and at 0.5, 1, 2 h of OLV (T2-4 ) and 1, 2 h of TLV (T5,6 ) and at 24 h after operation (T7) in group B and C for determination of serum SOD activity and TNF-α, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts. The same indexes were detected in group A at the corresponding time points.Results Serum SOD activity was significantly lower and serum TNF-α, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts were significantly higher in group B than in group A. Serum SOD activity was significantly higher and serum TNF-a, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts were significantly lower in group C than in group B. Conclusion Pretreatment with ambroxol 1 mg/kg can inhibit inflammatory response and lipid peroxidation during OLV.