间断静脉滴注环磷酰胺并服小剂量强的松治疗特发性肺纤维化的疗效观察

Intermittent,Intravenous Cyclophosphamide and Low Dose Prednisone for Idiopathic Pulmonary Fibrosis

以大剂量强的松(P组)治疗18例特发性肺纤维化(IPF)作为对照,与间断静脉滴注环磷酰胺(CTX)加小剂量强的松(C+P)组治疗的16例IPF患者进行了对比观察。C+P组的好转率为75％,动脉氧分压(PaO_2)由治疗前的6.80±2.13kPa升至8.98±2.20kPa(P<0.01),肺活量(VC)由1.46±0.57升至2.08±0.52升(P<0.01),患者对间断静脉应用CTX耐受良好,病死率6.25％。P组的好转率仅为27.6％,PaO_2和VC与治疗前相比均无显著变化(P>0.05),22.2％的患者出现明显的糖皮质激素副作用,病死率高达27.6％。研究表明,C+P是治疗IPF较好的方法,其疗效显著优于大剂量强的松,多数患者耐受良好。

We compared the effect of intermittent, intravenous cyclophosphamide (CTX) and low dose prednisone (C ± P) in 16 patients with idiopathic pulmonary fibrosis (IPF)with that of high dose prednisone alone(P)in 18 cases of IFF. After 3 months' treatment, of the 16 Patients in the group C ± P, 12 improved (75%), 1 died (6.25%). Their mean arterial oxygen tension(PaO2) and vital capacity (VC) were increased from 6.80±2.13kPa and 1.46±0.57 liters to 8.98±2.20kPa (P<0.01) and2.08± 0.52 liters (P<0.01) respectively. Patients were well tolerated to the use of intermittent, intravenous CTX. Of the 18 patients in the group P, however, only 5 improved (27.6%), and 5 died (27.6%). Their mean PaO2 and VC were not significantly changed before and after treatment (P>0.05). Four patients in group P developed serious co-rticosteroid side effects. The study showed that the intermittent, intravenous CTX and low dose prednisone therapy was better for IPF than high dose prednisone alone.