大剂量富露施对特发性肺间质纤维化患者肺功能的影响

Effect of High Dose Fluimuci1 on the Pulmonary Function of Patients with Idiopathic Pulmonary Fibrosis

目的探讨大剂量富露施对特发性肺间质纤维化患者肺功能的影响。方法将特发性肺间质纤维化患者随机分为两组,A组24例,每天口服强的松0·5mg/kg,4周后减半维持,同时口服富露施600mg/次,每天3次;B组24例,每天口服强的松0·5mg/kg,4周后减半维持。疗程均为3个月。观察临床表现、肺CT、血气、肺功能改变及症状缓解时间。结果A组患者的临床表现如气短、干咳、Velcro罗音经治疗后缓解率为66·7%,B组的缓解率为37·5%(P<0·05);A组缓解时间为(16·7±4·69)d,B组为(23·7±4·87)d(P<0·05);肺CT改善率在A组为62·5%,B组为29·2%(P<0·05)。A组患者治疗前后氧分压(PaO2)、百分肺活量(VC%)、一氧化碳弥散量(DLCO%)提高(P<0·05)。B组患者治疗前后PaO2、VC%、DLCO%有所提高,但与治疗前比较无显著性差异(P>0·05)。两组治疗后比较有显著性差异(P<0·05)。结论大剂量富露施能有效改善特发性肺间质纤维化患者的肺功能。

Objective To explore the effective methods to improve the pulmonary function and life quality of patients with idiopathic pulmonary fibrosis （IPF）. Methods 48 IPF patients were randomly divided into two groups, each group includes 24 cases. Group A was treated with prednisone 0.5 mg/kg per day orally, reduce half of the dosage 4 weeks later and Fluimucil 600 mg three times per day orally, while group B with prednisone 0.5 mg/kg per day orally, reduce half of the dosage 4 weeks later. The clinical manifestation, pulmonary function testing, high-resolution CT of the chest, arterial blood gas analysis were observed before and 3 months after treatment. Results There was significant difference in Group A （P〈0.05） but no significant difference in Group B （P〉0.05） before and after treatment in the pulmonary function testing and arterial blood gas analysis. There was significant difference after treatment in the pulmonary function testing and arterial blood gas analysis between Group A and Group B （P〈0.05）. There was significant difference after treatment in the clinical manifestation, high-resolution CT of the chest and between Group A and Group B （P〈0.05）. Conclusion High dose Fluimucil can ameliorate the pulmonary function, relieve the symptom of short breath of patients with idiopathic pulmonary fibrosis.