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外源性防御肽(佰润)对胸腔镜术后气道黏膜修复的影响

Effect of exogenous defensive peptide on airway mucosal repair after thoracoscopic surgery
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摘要 目的观察外源性防御肽(佰润)对胸腔镜插管球囊扩张后导致的气道术后并发症的作用。方法选取2015年1月至2018年1月山西医学科学院山西大医院胸外科收治的236例胸腔镜手术患者,依据术后治疗方法分为佰润组和对照组,每组分别分为吸烟组和非吸烟组。佰润组术后给予佰润雾化,对照组术后常规处理。以酶联免疫法分别测定术中、术后3d内源性防御肽LL-37、肿瘤坏死因子α、黏蛋白MUC-5ac的表达水平,观察术后气道黏膜损伤情况和咳痰情况。结果与术中比较,佰润组吸烟/非吸烟患者术后3d痰液中LL-37水平升高(P<0.05或P<0.01)。2组吸烟/非吸烟患者术后3d与术中比较,痰液中肿瘤坏死因子α水平差异无统计学意义。对照组非吸烟患者和佰润组吸烟患者术后3d与术中比较,痰液中MUC-5ac水平差异有统计学意义(P<0.05或P<0.01)。术后3d,佰润组吸烟/非吸烟患者痰液中MUC-5ac水平低于对照组吸烟/非吸烟患者(P值均<0.05)。佰润组和对照组吸烟/非吸烟患者术后3d与手术结束时比较黏膜损伤情况差异有统计学意义(P<0.05或P<0.01);术后3d,佰润组吸烟/非吸烟患者与对照组吸烟/非吸烟患者比较黏膜损伤情况差异有统计学意义(P值均<0.01)。佰润组吸烟/非吸烟患者与对照组吸烟/非吸烟患者比较咳痰情况差异有统计学意义(P值均<0.01)。结论外源性防御肽可通过适当提高具有修复功能防御肽LL-37的表达水平,促进气道损伤修复,减少出血。通过调节黏蛋白预防术后应激性咳嗽咳痰,全面改善胸腔镜术后愈合。佰润在预防胸腔镜术后咳痰和修复气道黏膜损伤方面,较常规治疗有显著性优势。 Objective To evaluated the effect of exogenous defensive peptide on airway complication caused by balloon dilatation after thoracoscopic intubation. Methods 236 thoracoscopic surgery patients in Department of Thoracic Surgery, Shanxi Dayi Hospital, Shanxi Academy of Medical Sciences from January 2015 to January 2018 were collected. They were divided into Bioron group and control group according to treatment after surgery, with half of smokers in each group. Bioron group was treated with Bioron atomized, while control group was given routine treatment after surgery. The expression levels of LL-37, tumor necrosis factor-a and MUC-5ac were measured by enzyme-linked immunosorbent assay during surgery and after treatment for three days. The airway mucosal injury and expectoration after operation were observed. Results The level of LL-37 in sputum of smokers or non-smokers in Bioron group on the third day after operation was higher than that during operation ( P <0.05 or P <0.01). There was no significant difference in the level of tumor necrosis factor-a in sputum of smokers or non-smokers in two groups during operation and on the third day after operation. The MUC-5ac level in sputum of non-smokers in control group and smokers in Bioron group on the third day after operation was significantly different from that during operation ( P<0.05 or P<0.01). On the third day after operation, the MUC-5ac level in sputum of the smokers or non-smokers in Bioron group was lower than that in control group (all P<0.05). The mucosal injury of smokers or non-smokers in Bioron group and control group on the third day after operation was different from that at the end of operation ( P < 0.05 or P V0.01). On the third day after operation, there was significant difference in mucosal injury between smokers or non-smokers in Bioron group and smokers or non-smokers in control group (all P <0.01). There was significant difference in sputum between smokers or non-smokers in Bioron group and smokers or non-smokers in control group (all P < 0.0
作者 柴立勋 杨更朴 Chai Lixun;Yang Gengpu(Department of Thoracic Surgery, Shanxi Dayi Hospital, Shanxi Academy of Medical Sciences, Taiyuan 030032, China)
出处 《国际呼吸杂志》 2019年第8期584-588,共5页 International Journal of Respiration
关键词 抗菌肽类 佰润 胸腔镜检查 气管插管 麻醉 气道损伤 黏膜修复 Antimicrobial peptide Bioron Thoracoscopy Tracheal intubation Anesthesia Airway injury Mucosal repair
作者简介 通信作者:柴立勋,Email:chailixun.163.com.
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