The Lung Protective Effects Of Ambroxol In Perioperative Undergoing Cardiopulmonary Bypass

Objective:To investigate the lung protective effects of ambroxol in perioperative undergoing cardiopulmonary bypass(CPB).Methods:Forty patients for valve replacement were randomly divided into ambroxol group(group A) and control group(group C) with 20 cases each from 2006 to 2007. 150mg ambroxol was added to the priming solution in group A and same volume of normal saline as that in group C.Four milliliter blood sample were taken before CPB (T₁),at 30 min after start of CPB(T₂),30 min after aotic declamping(T₃),30 min after termination of CPB(T₄),4h(T₅),24h(T₆).after operation for determination of plasma TNF-α,IL-1β,IL-10,MDA concentration,SOD activity,arterial blood gas and respiratory index(RI).A bronchioalveolarlavage(BAL) was performed at 2 hours after the end of cardiopulmonary bypass.To telphospholipid(TPL),saturated phosphatidylcholine(SatPC) and totel protein(TP) in the BALF were measured,and lung oxygenateindex(OI) were measured at 2 hours after CPB termination.Record the airway pressure and time of mechanical ventilation and ICU.Results:TNF-α:level of two group were all high at T₂- T₄.level of group C wes high at T₅,T₆.level at T₂-T₆ in group A was lower than that in group C(P＜0.05).IL-1β: level of two group were all high at T₂-T₅.level at T₂-T₅ in group A was lower than that in group C(P＜0.05).IL-10:level of two group were all high at T₂-T₅.level at T₂-T₅ in group A was higher than that in group C(P＜0.05).MDA level at T₂-T₆ was high in group C than T₁ in group C,at T₃-T₄ was high in group A,and level at T₂,T₃,T₅ in group A was lower than that in group C(P＜0.05).SOD activity at T₂-T₅ was lower in group C than that in group A(P＜0.05).RI:there was no difference compared between group C and group A at T₁,T-2(P＞0.05).level of two group were high at T₃-T₅,and level at T₃-T₅ in group A was lower than that in group C(P＜0.05).OI was significantly lower in group A than that in group C(P＜0.005).SatPC/TPL and SatPC/TP of the group A in the BALF was significantly higher than that of the group C(P＜0.05).The time of intubation and time of ICU was significantly shorter in group A than that in group C.The airway pressure was lower in group A than that in group C(P＜0.05).Conclusion:Ambroxol has protective effect on perioperative lung injury after CPB by reducing inflammatory cytokines release,as well as oxygen free radical release, and promoting anti-inflamatory cytokines release and ecretion of PS.The time of intubation and time of ICU were shorter.