N-乙酰半胱氨酸对特发性肺纤维化患者血清转化生长因子β1和白细胞介素13的影响

Effects of N-acetylcysteine TGF-β1 and IL-13 on idiopathic pulmonary fibrosis

目的探讨N-乙酰半胱氨酸对特发性肺纤维化患者血清转化生长因子β1（TGF-β1）和白细胞介素13（IL-13）的影响。方法122例特发性肺纤维化患者按就诊顺序分2组。治疗组62例，每天口服强的松0．5mg／kg，4周后减半维持，同时口服N－乙酰半胱氨酸600mg/次，3次／d。对照组60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2组患者临床表现，肺高分辨率CT表现，血气分析，肺功能改变及症状缓解时间。TGF-β1和IL-13在治疗前后被测定。结果经治疗治疗组改善58例（93．5％）；对照组48例（80．0％），2组差异有统计学意义（P〈0．05）。治疗组治疗后的TGF-β1和IL-13分别为（46．8±19．7）μg／L、（76．9±20．1）g／L均较治疗前[（118．1±31．2）斗g／L与（152．4±28．4）g／L]有明显改善，与对照组[（86．3．4-29．6）μg／L、（121．5±22．5）g／L]相比，差异有统计学意义（P〈0．05）。结论N-乙酰半胱氨酸改善症状和体征可能通过改善TGF-β1和IL-13而达到。

Objective To investigate the significance of expression of transforming growth factor β1 （TGF-β1） and interleukin 13 in patients with idiopathic pulmonary fibrosis（ IPF） though Fluimucil. Methods One hundred and twenty-two IPF patients were randomly divided into two groups. Treatment group included 62 cases treated with prednisone 0.5 mg/kg per day orally and the dosage was reduced 50% 4 weeks later and Fluimucil 600 mg three times per day. Control group included 60 cases receiving prednisone 0.5 mg/kg per day orally and a half dosage 4 weeks later. The clinical manifestation, pulmonary function testing, high-resolution chest CT, arterial blood gas analysis were observed before and 3 months after treatment. Results After treatment of 3 months, the improvement rate of symptoms and signs in the treatment group was superior to that in the control group（P 〈 0.05 ）. The serum levels of TGF-β1 and IL-13 in the treatment group were decreased significantly（P〈0.05）. Conclusion Fluimucil can improve symptoms and signs of the patient with pulmonary interstitial fibrosis via decreasing TGF-β1 and IL-13.