目的 研究氨溴索静脉用药联合不同通气方式治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效。方法 选取2019年2月—2021年1月我院收治的98例NRDS患儿,根据治疗方案不同分为对照组(49例)和观察组(49例)。2组均给予常规治疗,对照组采用氨溴索静脉用药、常规机械通气治疗,观察组采用氨溴索静脉用药、高频振荡通气(HFOV)治疗。比较2组临床疗效、胸部X线评分、新生儿评分(Apgar评分)、不同时间点(治疗前、治疗后2 h、治疗后12 h)动脉血气指标[氧合指数(OI)、动脉氧分压(PaO₂)、动脉血二氧化碳分压(PaCO₂)]、呼吸力学指标[呼吸指数(RI)、呼吸道阻力(R)、肺动态顺应性(Crs)]、并发症发生率、死亡率。结果 2组治疗后总有效率比较,观察组93.88%高于对照组77.55%(P＜0.05);治疗后,观察组胸部X线评分、Apgar评分均高于对照组(P＜0.05);治疗后2 h、治疗后12 h时观察组OI、PaCO₂均低于对照组,PaO₂高于对照组(P＜0.05);治疗后,观察组RI、AR水平低于对照组,Crs水平高于对照组(P＜0.05);观察组死亡率2.04%低于对照组14.29%(P＜0.05)。结论 氨溴索静脉用药联合HFOV治疗NRDS的临床疗效显著,可有效促进患儿呼吸功能、动脉血气改善,降低新生儿死亡率。

目的 调查盐酸氨溴索对放射性肺损伤中转化生长因子β1(TGF-β1)以及肿瘤坏死因子α(TNF-a)水平的影响。方法 选取共98例在放射治疗局部晚期肺癌患者,随机分为治疗组和对照组。自放疗开始予治疗组中患者盐酸氨溴索口服,剂量60 mg,每天三次,持续应用3个月。然后对两组患者血浆中TGF-β1和TNF-α的水平进行分析。临床症状和病情变化情况采用高分辨率计算机断层扫描进行检测。结果 对照组中TGF-β1水平显著升高(11.8±5.5 ng/mL),而在盐酸氨溴索治疗组中,增加不显著(5.5±2.6 ng/mL,P＜0.001)。同样,对照组中TNF-α的水平也较治疗组中升高,(对照组:5.1±1.3,治疗组:2.6±0.8 ng/mL,P＜0.001)。结论 盐酸氨溴索能有效降低放疗后血浆TGF-β1及TNF-α水平,降低早期出现的放射性肺炎和晚期出现的肺纤维化发生机率,提高治疗效果及患者生活质量。

Objective The aim is to investigate the effect of ambroxol on radiation lung injury and the expression of transforming growth factor β1(TGF-β1),and tumor necrosis factor α(TNF-α)in plasma. Methods Ninety-eight patients with locally advanced lung cancer in radiotherapy were randomized into treatment and control groups.Patients in the treatment group took ambroxol orally at a dosage of 60 mg,three times per day for 3 months from the beginning of radiotherapy.The expression of TGF-β1 and TNF-αin plasma was analyzed.The clinical symptoms and lung diffusing capacity were monitored using high resolving power computed tomography. Results The level of TGF-β1 in the control group was increased(11.8 ± 5.5 ng/mL),whereas in ambroxol-treated patients,the increase was not significant(5.5 ± 2.6 ng/mL,P＜0.001). Radiotherapy-induced elevation of TNF-α levels,seen in control patients,was also abolished after treatment with ambroxol(5.1 ± 1.3 vs 2.6 ± 0.8 ng/mL,P＜0.001). Conclusion Ambroxol can obviously decrease the plasma TGF-β1 and TNF-α levels after radiotherapy,and decrease the chances of early radiation pneumonitis and late pulmonary fibrosis,and improve treatment effect and quality of life of patients.

目的 探讨孕母产前应用盐酸氨溴索对新生儿呼吸窘迫综合征(NRDS)发病影响。方法 选取我院自2012年10月—2014年10月间收治的有早产征象的孕妇248例作为研究对象,根据孕周情况将其分成两组,即A组孕妇的孕周≤35周,B组孕妇孕周＞35周,又将两组患者随机分成两组,即A-对照组患者,A-观察组;B-对照组和B-观察组,分别对其对照组孕妇行常规药物治疗,观察组患者采用盐酸氨溴索进行治疗,对比4组新生儿的呼吸窘迫发生情况。结果 A-对照组新生儿窘迫的发生率为 (18)29.03%,B-对照组该数据为(25)40.32%;A-观察组新生儿呼吸窘迫的发生率为(8)12.90%,B-观察组该数据为(14)22.58%,两组数据对比有统计学意义,P＜0.05。结论 孕周＜35周是产前应用盐酸氨溴索预防新生儿呼吸窘迫的最佳时机。

Objective To investigate maternal antenatal ambroxol hydrochloride incidence of neonatal respiratory distress syndrome affected. Methods Since our hospital between October 2012-2014 October has admitted 248 cases of pregnant women with preterm labor signs as research subjects, according to the gestational age of the case will be divided into two groups, Group A pregnant woman's gestational age ≤35 weeks Group B pregnant gestation> 35 weeks, patients were randomly divided into two groups in turn, that the patients in the control group A-, A-observation group; B-B-observation group and control group, respectively, to its line of conventional drugs for pregnant women in the control group treatment, observation group were treated with ambroxol hydrochloride for treatment, compared to four groups of neonatal respiratory distress happen. Results A-control group incidence of neonatal distress (18) 29.03%, B-group the data (25) 40.32%; A-observation group incidence of neonatal respiratory distress (8) 12.90%, B-The data for the observation group (14) 22.58%, comparing two sets of data were statistically significant difference, P<0.05. Conclusion gestational age <35 weeks is ambroxol hydrochloride prenatal prevention of neonatal respiratory distress best time.