The Effect Of Ambroxol Therapy In The Premature Neonate With RDS And The Changes Of Serum 8-iso-PGF2α Level

Objective To analysize the changes of serum 8-iso-PGF2 a level for the premature neonate with respiratory distress syndrome (RDS) before and after ambroxol therapy, investigate lipid peroxidation damage mechanism of RDS premature neonates and ambroxol effect against peroxidation damage. To analysize the correlation of 8-iso-PGF2αlevels between serum and urine, assess the clinical value of urine 8-iso-PGF2αdetermination.Methods 58 RDS premature neonates (gestational age 28-34 weeks) were selected, and divided into three groups:Group A,20 cases used routine dosage therapy of ambroxol; Group B,20 cases used large dosage therapy of ambroxol; and Group C,18 cases used the conventional treatment as control. The conventional treatment for RDS included support therapy, oxygen therapy (head Mask, CPAP or CMV) and PS therapy and so on. On the basis of the conventional treatment,10mg/kg·d or 30mg/kg·d dosages of ambroxol were taken via vein for 3days in group A, B respectively. The use of ambroxol started at 6 hours after birth. Peripheral blood samples were collected 6 hours and 4 days after birth, i.e. before the start and end of ambroxol therapy. Serum 8-iso-PGF2a levels were determined by ELISA.Results①Serum 8-iso-PGF2a levels in Group A were 213.08±55.24 pg/ml before the start of ambroxol therapy, elevated up to 244.84±41.81 pg/ml after the end of ambroxol therapy (t=2.0502, p=0.0473).②Serum 8-iso-PGF2a levels in Group B were 211.98±63.64pg/ml before the start of ambroxol therapy, fallen down to 164.63±51.12pg/ml after the end of ambroxol therapy (t=2.05941, p=0.0134).③Serum 8-iso-PGF2a levels in Group C were 202.78±42.82pg/ml 6 hours after birth, and raised to 304.29±74.20pg/ml 4 days after birth (t=5.0271, p=0.0000).④Serum 8-iso-PGF2a levels among Group A, B, C had no significant difference 6 hours after birth(F=0.197, P=0.8215). Serum 8-iso-PGF2a level in Group A was lower than that in Group C (t=3.0831, p=0.0039), Serum 8-iso-PGF2 a level in Group B was. much lower than that in both Group A and Group C (t=5.4317, p=0.0000; t=6.8146, p=0.0000).⑤rine 8-iso-PGF2a level was 41.62±7.82 pg/ml in the neonates with RDS, and there was a positive correlation between serum and urine(t=7.2319, P=0.0000).Conclusions There are lipid peroxidation damage in RDS premature infant, and their serum 8-iso-PGF2a level rises along with the illness course. The large dose use of ambroxol reduces serum 8-iso-PGF2a level, and display a good anti-oxidation effect. Urine 8-iso-PGF2 a determination have marked clinical value for the assess of lipid peroxidation.