【摘要】 目的 观察机械通气对黏蛋白（mucin，MUC）-5AC表达的影响及复方川贝精片的干预作用。 方法 新西兰兔25只，6个月龄，雄性；随机分为对照组、机械通气12 h组及复方川贝精片低、中、高剂量组。收集支气管灌洗液，分别采用实时荧光定量聚合酶链式反应法和酶联免疫吸附试验检测支气管灌洗液中p38 MAPK mRNA，MUC-5AC蛋白和mRNA的表达。 结果 机械通气能增强MUC-5AC的分泌（Plt;0.05）；加用复方川贝精片能降低机械通气后MUC-5AC蛋白和mRNA的表达（Plt;0.05）；复方川贝精片中、高剂量组与低剂量组比较，能降低机械通气后MUC-5AC蛋白和mRNA的表达（Plt;0.05）。 结论 机械通气能促进支气管黏膜上皮细胞分泌MUC-5AC，复方川贝精片能抑制机械通气所致MUC-5AC表达升高，其机制可能与其抑制p38 MAPK表达有关。【Abstract】 Objective To observe the effect of mechanical ventilation by breathing machine on the expression of mucin (MUC-5AC) and the interfering effect of compound tablet of fritillary bulb. Methods New Zealand Rabbits were randomly divided into control group, twelve-hour mechanical ventilation group, and low, medium and high-dose compound tablet of fritillary bulb group. Contents of p38 MAPK mRNA, MUC-5AC mRNA and protein in bronchial irrigating solution were detected by realtime RT-PCR and ELISA methods. Results Mechanical ventilation could increase the expression of MUC-5AC in bronchial irrigating solution (Plt;0.05). Compound tablet of fritillary bulb could decrease the expression of MUC-5AC mRNA and protein after mechanical ventilation (Plt;0.05). Compared with low-dose compound tablet of fritillary bulb group, the expression of MUC-5AC mRNA and protein was lower for the high and medium-dose groups (Plt;0.05). Conclusions Mechanical ventilation can promote the expression of MUC-5AC in bronchial endothelial cells, which can be suppressed by compound tablet of fritillary bulb. This may be due to the suppression effect of p38 MAPK expression.
目的 观察噻托溴铵治疗慢性阻塞性肺疾病急性加重期（AECOPD）临床疗效与安全性。 方法 选取 2010 年 1 月－2011年12月入院的69例AECOPD 患者随机分为试验组（A组，n=36）和对照组（B组，n=33），A组在B组常规治疗的基础上吸入噻托溴铵。治疗起始及结束分别观察两组肺功能指标、慢性阻塞性肺疾病评估测试（CAT）评分、血气分析、6分钟步行距离、住院时间及药物不良反应。 结果 两组均显示出一定的临床效果，A组治疗后肺功能指标、CAT评分、血气分析、6分钟步行距离均优于B组，差异均具有统计学意义（P＜0.05）。A组住院时间短于B组（P＜0.05），且无严重不良反应。 结论 AECOPD患者在常规治疗同时吸入噻托溴铵，疗效显著且临床安全性较高。