Large Dose Of Ambroxol Hydrochloride For Lung Protection By Short-term Perioperative Treatment In Aged Patients With Lung Cancer

Objective To investigate the risk factors resulting in lower FEV1in aged patients with NSCLC. To assess in a clinical trial the influence of preoperative short-term ambroxol administration (large-dose,1Omg/kg) for lung protection after pulmonary lobectomy. Further study the relationship between lung protection of ambroxol and FEV1.Methods71patients over60years old for pulmonary lobectomy were divided into two layers (A-layer:FEV1<1.5L;B-layer:FEV1>1.5L) according to FEV1values before admission. Clinical data including of Gender, age, body mass index(BMI), smoking index, pathological type, degree of differentiation of lung cancer, TNM stage and plasma index were analyzed to investigate the risk factors to lower FEV1.According to the principal of random and control,the two layers(A、B) were divided into four groups.A1group (Lower-FEV1control group, n=15), A2group (Lower-FEV1ambroxol group, n=16), B1group (High-FEV1control group,n=19),B2group (high-FEV1ambroxol group,n=21). Group A2and B2, respectively, until3days before surgery, intravenous infusion10mg/kg dose of ambroxol. Same volume of saline for group A1and B1. Blood sample were taken from vein before surgery and day1,3,5after operation. The research indexes are PAF、PCT、MDA、SOD、ICAM-1、SP-A. Results1:The two layers(A、B):smoking index, TNM stage, preoperative SOD, MDA, and ICAM-1, the SP-A, had statistically significant differents(P＜0.05) and gender, age, pathological type, degree of differentiation, preoperative of PAF,PCT had no significances (P＞0.05)2:The level of all plasma indexes increased in some days after operation (P<0.05).And all in groupA1or B1were higher than of A2or B2and had stastistical significance in the same point and overall curve. Ambroxol hydrochloride in short-term perioperative treatment began in the third postoperative day (P<0.05)3:PAF、PCT and SP-A had ststistical significance at the first day after surgery in the group A1and A2,or B1and B2. While SOD、MDA and ICAM-1had significance discrepancy at the third day (P<0.05)4:MDA had significance discrepancy at the third and fifth day between the group A2and B2(P<0.05). While other indexes had no stastistical significance in overall time after operation (P>0.05)Conclusion1:The statistically significant risks of lower FEV1: smoking index (>400pack-years),TNM staging (IIIA).2:Ambroxol has protective effect on perioperative lung injury after pulmonary lobectomy by reducing inflammatory eytokine release, oxygen free radical release, and regulating the secretion of SP-A. The lung protection have significance discrepancy begins at the third day. 3.In the FEV1＞1.5L patients, using ambroxol has better antioxidant effect(p<0.05). While to anti-inflammatory and metabolic regulation of ambroxol have no correlations with FEV1.