1.Clinical significance of inhaling ambroxol hydrochloride in airway inflammation in elderly patients with chronic obstructive pulmonary disease
Wailong ZOU ; Hong JI ; Xinmin LIU
Chinese Journal of Geriatrics 2008;27(7):521-524
Objective 1.To establish an improved method by inhaling hyperosmotic saline and mucosolvan ampoule and to observe the security and validity in elderly patients with chronic obstructive pulmonary disease(COPD).2.To observe the changes of cell component and soluble substance in the induced sputum of the elderly patients with COPD at their acute and stable stage,and explore the role of these substances in airway inflammation. Methods 1.40 elderly patients with COPD who were at their acute stage were stochastically divided into two groups,20 patients each,who inhaled hyperosmotic saline(3%)(group A)and hyperosmotie saline(3%)plus ambroxol hydrochloride(group B).We compared their electrocardiogram before and after inhalation,lung function,saturation of oxygen in artery,cell component,inflammatory factors in sputum and validity of inducing sputum.2.The cell component,inflammatory factors and the lung function of the patients in group B were determined at their acute and stable stage. Results 1.55.0% of the patients in group A felt uncomfortable.and 2 of them had excessive bronchial irritability so not undergoing sputum inducement.However,side effects were found in only 5 patients of the group B.Side effects in the group B were lower than those in hyperosmotic saline group(P<0.05).Before and after the experiment,electrocardiogram of the patients in the two groups had no statistical difference(P>0.05).It was the same as lung function and oxygenic saturation.Cell component and inflammatory faetors in the sputum of the two groups had no statistical difference(P>0.05).2.In group B,the total cells,monoeyte,neutrophil,IL-8 and TNF-αof the patients at their acute stage were(3.4 5±0.52)×108/L,(38.8±4.3)%,(30.8±3.1)%,(316.75±43.14)ng/L,(39.4±4.58)ng/L.respectively.And those at their stable stage were(2.94±0.57)×108/L,(29.1±6.1)%,(28.2±4.2)%,(170.00±25.70)ng/L,(20.60±5.10)ng/L,respectively.The total cells,monocyte,neutrophils,IL-8 and TNF-α in acute and stable stage of the patients had statistical significance(P<0.05).There was a negative correlation of the total cells,monocyte,neutrophil,IL-8,TNF-αwith the degree of the disease in group B at acute and stable stage. Conclusions The results suggest that inhaling ambroxol hydrodiloride is a practical,safe and effective method,for clarifying the mechanism of airway inflammation in elderly patients with COPD.