干扰素-γ、N-乙酰半胱氨酸及小剂量强的松联合治疗特发性肺纤维化疗效分析

Curative Effect of Combination of Interferon-γ,N-acetylcysteine and Low Dose Prednisone on Idiopathic Pulmonary Interstitial Fibrosis

目的:探讨干扰素-γ、N-乙酰半胱氨酸及小剂量强的松联合治疗特发性肺纤维化的疗效。方法:将31例特发性肺纤维化患者随机分成A、B、C三组,A组单用小剂量强的松治疗,B组给予干扰素-γ加小剂量强的松治疗,C组给予干扰素-γ,N-乙酰半胱氨酸及小剂量强的松联合治疗;分别于治疗前,治疗第4周、12周及24周测FVC、FEV1/FVC、MVV、TLC及PaO2,并分析其变化。结果:治疗前后FEV1/FVC、MVV实测值/预计值在三组均没有统计学差异,FVC实测值/预计值、TLC实测值/预计值及PaO2三组各组组内比较,在治疗前后A组没有统计学差异,B组和C组治疗后较治疗前有统计学差异(P<0.05),尤其C组明显;C组与A、B组比较,FVC实测值/预计值、TLC实测值/预计值及PaO2升高,有明显统计学差异(P<0.05)。结论:干扰素-γ、N-乙酰半胱氨酸及小剂量强的松联合治疗特发性间质性肺炎能够在一定程度上改善患者肺功能。

To explore the curative effect of combination of interferon-y（ IFN-y, N-acetylcysteine and small dosage prednisone on idiopathic pulmonary interstitial fibrosis （IPF）. Methods： Thirty one patients with IPF were randomly divided into three groups. Patients in groups A, B, C were treated with low dose prednisone only, low dose prednisone plus IFN-y, and low dose prednisone plus IFN-y and N-acetylcysteine respectively. Forced vital capacity （FVC） , forced respiratory volume in one second/FVC （FEV1/FVC）, maximal vital volume （MVV）, total lung capacity （TLC） and PaO2 were detected before treatment and in 4, 12, and 24 weeks after treatment. The changes were analyzed. Results： No significant difference was found in FEV1/FVC and measured.value/predicting value of MVV before and after treatment in all the 3 groups. In group A, no significant difference was found in PaOν2, measured value/predicting value of FVC and TLC before and after treatment, but in group B and C, the differences were significant（P 〈0.05）and more obvious changes were found in group C. PaOν2, measured value/ predicting value of FVC and TLC were higher in group C than those in other two groups, and the differences were significant（P 〈0.05）. Conclusions： Combined use of IFN-y, N-acetylcysteine and low dose prednisone in the treatment of IPF can ameliorate lung function of patients.