安体舒通联合强的松治疗特发性肺纤维化

Effects of Spironolactone Combined with Prednisone on Patients with Idiopathic Pulmonary Fibrosis

目的：探讨安体舒通联合强的松治疗特发性肺纤维化（Idiopathic pulmonary fibrosis，IPF）的临床疗效和安全性。方法：将IPF患者22例随机分为两组：治疗组12例，安体舒通联合强的松治疗；对照组10例，单用强的松治疗。观察咳嗽和呼吸困难等症状、胸部HRCT和肺功能、血电解质和血压。结果：治疗1月两组均有明显疗效，反应良好者治疗组达8例（75％），对照组8例（80％）；疗程12月，治疗组反应良好者为6例（50％），对照组3例（30％），P〈0．05。对照组有1～2例（10％～20％）患者发生低血钾和高血压，治疗组则没有发生。结论：与单用强的松相比，安体舒通联合强的松能提高IPF的疗效，比单用强的松副反应减少。

Objective To observe the therapeutic effects of spironolactone combined with prednisone on patients with idiopathic pulmonary fibrosis （IPF）. Methods Twenty - two patients were randomly divided into 2 groups：the spironolactone combined with prednisone group（ n = 12 ） , prednisone group （n = 10） . All patients were followed up for 12 months. The changes of the dyspnea ,cough, blood pressure, and the index changes of high resolution computerized tomography of chest, lung function test, arterial blood gas detection, the level of potassium and sodium in sermn were observed during the treatment. Results After 1 month follow - up, there was 8 patients who had better therapeutic effect in both group, respectively. After 12-month followup, there were still 50% patients （6/12） in good conditions in spironolaction combined with prednisone group. However, there were only 30% patients （3/10） in good conditions in prednisone group（ P 〈 0.05 ）. The hypopotassemia or high blood pressure occurred about 10%-20% in prednisone group, however, there wasnt happened in spironolactone combined with prednisone group. Conclusion Compared to treat only with prednisone, spironolactone combined with prednisone could improve the therapeutic effects on the IPF, it could decrease the incidence of hypopotassemia or high blood pressure which takes place in prednisone therapy alone.