[关键词]
[摘要]
目的 探究环孢素联合泼尼松治疗特发性肺间质纤维化的临床疗效。方法 选取2017年1月—2018年1月喀什地区第二人民医院医治的特发性肺间质纤维化患者62例作为研究对象,将患者按照随机数字表法均分为对照组(n=31)和观察组(n=31)。对照组的患者口服醋酸泼尼松龙片,剂量为15 mg/d,连续治疗2个月,而后减量至5~10 mg/d,连续治疗3个月。观察组患者在对照组治疗基础上静脉滴注环孢素注射液,2.5 mg应用5%葡萄糖液稀释后缓慢静滴,1次/d,持续2周;随后口服维持量5 g/d,持续治疗3个月。两组疗程均为5个月。观察两组患者的临床疗效,比较两组治疗前后的肺功能指标、免疫功能指标、炎性因子、环瓜氨酸多肽(CCP)和C反应蛋白(CRP)水平。结果 治疗后,观察组和对照组治疗有效率为96.77%和80.65%,两组对比的差异存在统计学意义(P<0.05)。治疗后,两组患者用力肺活量(FVC)、第1秒用力呼气容积(FEV1)和FEV1/FVC水平均显著升高,同组治疗前后比较差异有统计学意义(P<0.05);观察组FVC、FEV1、FEV1/FVC水平均显著高于对照组(P<0.05)。治疗后,两组患者CD4+、CD3+水平均显著升高,同组治疗前后比较差异有统计学意义(P<0.05);观察组CD4+、CD3+水平显著高于对照组(P<0.05)。治疗后,两组患者白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、CCP和CRP水平均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);观察组IL-1β、TNF-α、CCP和CRP水平显著低于对照组(P<0.05)。结论 环孢素联合泼尼松对特发性肺间质纤维化具有较好的治疗效果,能够改善患者的免疫功能和炎性指标,降低患者CCP和CRP水平有关,值得进行临床推广使用。
[Key word]
[Abstract]
Objective To investigate the clinical efficacy of ciclosporin combined with prednisone in treatment of idiopathic pulmonary fibrosis. Methods A total of 62 patients with idiopathic pulmonary fibrosis treated in the Kashi Second People's Hospital from January 2017 to January 2018 were selected as the research objects, and the patients were divided into control group (n=31 cases) and observation group (n=31 cases) according to the random number table method. Patients in the control group were po administered with Prednisolone Acetate Tablets at a dose of 15 mg/d for two consecutive months, and then reduced to 5-10 mg/d for three consecutive months. Patients in the observation group were iv administered with Ciclosporin Injection on the basis of control group, 2.5 mg was diluted with 5% glucose solution, once daily, lasting for two weeks. Then the oral maintenance dose was 5 g/d, and the treatment lasted for three months. Patients in two groups were treated for three months. The clinical efficacy in two groups was observed, and the levels of lung function, immune function, inflammatory factors, cyclic citrinine polypeptide (CCP) and Creactive protein (CRP) between two groups before and after treatment were compared. Results After treatment, the effective rate in the observation group and control group was 96.77% and 80.65%, with statistically significant difference between two groups (P<0.05). After treatment, the levels of FVC, FEV1 and FEV1/FVC in two groups were significantly increased, and the difference before and after treatment in the same group was statistically significant (P<0.05). The levels of FVC, FEV1 and FEV1/FVC in the observation group were significantly higher than those in the control group (P<0.05). After treatment, the levels of CD4+ and CD3+ in two groups were significantly increased, and the difference before and after treatment in the same group was statistically significant (P<0.05). The levels of CD4+ and CD3+ in the observation group were significantly higher than those in the control group (P<0.05). After treatment, the levels of IL-1β, TNF-α, CCP, and CRP in two groups were significantly decreased, and the difference before and after treatment in the same group was statistically significant (P<0.05). The levels of IL-1β, TNF-α, CCP, and CRP in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Ciclosporin combined with prednisone has a good therapeutic effect on idiopathic pulmonary fibrosis, can improve the immune function and inflammatory indicators of patients, and reduce the CCP and CRP levels in patients, which is worthy of clinical promotion.
[中图分类号]
R974
[基金项目]
喀什地区科学研究与技术开发计划项目(KS2018016)