Study on the Efficacy and Safety of Ambroxol Combined with Methylprednisolone in Patients with Acute Lung Injury.

Background: There is no better treatment method towards paraquat-induced acute lung injury (ALI) at present. Ambroxol combined with methylprednisolone exhibits a significant improvement effect on ALI treatment, whereas their mechanism in ALI is still unclear.

Methods: 64 patients with ALI caused by paraquat poisoning brought to our hospital from January 2015 to January 2018 were selected. They were separated into a combined treatment group (CTG) and a routine treatment group (RTG) on the basis of different treatment methods. The survival of patients was observed after 7 days of treatment. Arterial blood gas, oxygen partial pressure (PaO), partial pressure of carbon dioxide (PaCO), oxygenation index (PaO/FiO), patient's spontaneous respiratory rate (RR), tidal volume (VT), and positive end-expiratory pressure (PEEP) were observed before and after treatment for 7 days. Interleukin 6 (IL-6) and tumor necrosis factor (TNF-) were analyzed. The differences of indexes between the dead patients and the survivors were observed, and the potential predictive value of death was analyzed.

Results: After treatment, the indexes of patients were significantly improved in both groups compared with those before therapy. Further comparison showed that the improvement of PaO, PaCO, and PaO/FiO in CTG was obviously higher than that in RTG ( < 0.05). The improvement of RR, PEEP, and VT in CTG was obviously higher than that in RTG ( < 0.05). The decreased degree of IL-6 and TNF- in CTG was higher than that in RTG ( < 0.05). The 7-day mortality rate of 64 patients was 39.06%, and there was no obvious difference in the 7-day survival rate in both groups ( = 0.649). IL-6 and TNF- were expected to be potential prediction indexes of paraquat-induced ALI.

Conclusion: Ambroxol combined with methylprednisolone significantly improved the oxygen partial pressure and oxygenation index of patients with paraquat-induced ALI and inhibited the inflammatory response of patients.