沐舒坦讲稿2.pptx.ppt

Abstract Ambroxol [trans-4-(2-amino-3,5-dibromobenzylamino)-cyclohexanole hydrochloride], a mucolytic agent, was postulated to provide surfactant stimulatory properties and was previously used to prevent surfactant deficiency. Currently, the underlying mechanisms are not exactly clear.Because surfactant homeostasis is regulated by surfactant-specific proteins (SP), we analyzed protein amount and mRNA expression in whole lung tissue, isolated type II pneumocytes and bronchoalveolar lavage of Sprague–Dawley rats treated with ambroxol i.p. (75 mg/kg body weight, twice a day [every 12 h]). The methods used included competitive polymerase chain reaction (RT-PCR), Northern blotting, Western immunoblotting, and immunohistochemistry. In isolated type II pneumocytes of ambroxol-treated animals, SP-C protein and mRNA content were increased, whereas SP-A, -B and –D protein, mRNA, and immunoreactivity remained unaffected. However, ambroxol treatment resulted in a significant increase of SP-B and in a decrease of SP-D in whole lung tissue with enhanced immunostaining for SP-B in Clara Cells. SP-A and SP-D were significantly decreased in BAL fluid of ambroxol-treated animals. The data suggest that surfactant protein expression is modulated in a cell-specific manner by ambroxol, as type II pneumocytes exhibited an increase in SP-C, whereas Clara cells exhibited an increase in the immunoreactivity for SP-B accounting for the increased SP-B content of whole lung tissue. The results indicate that ambroxol may exert its positive effects, observed in the treatment of diseases related to surfactant deficiency, via modulation of surfactant protein expression. * * * 对于多发性创伤病人的治疗，除了特殊的重症医学基础治疗以外，肺功能的恢复和保持具有重要的意义。由于表面活性物质系统在此起着关键作用，因此刺激表面活性物质生成的物质的应用，如沐舒坦应当用于治疗之中。并且众多的研究证实，氨溴索不仅刺激表面活性物质的生成，可能还抑制在病理现象中起决定作用的氧自由基的产生。 德国Murnauer创伤医院对于吸入性创伤和多发性创伤病人的稳定肺功能的治疗的常规步骤主要包括6步。 * 一般来说，对于可能的ARDS患者应该尽早静脉输注沐舒坦。ARDS的第一阶段是发展成肺间质水肿。此时即应该开始使用氨溴索治疗，最迟也应该在第二阶段开始，第二阶段的特征是气道的痉挛和通气压力的升高。在静脉注射氨溴索的过程中进展到第三阶段，即过多分泌