肺灌洗治疗尘肺合并COPD的疗效及对炎性因子的影响

Effects of lung lavage on inflammatory factors and the effect of coal worker's pneumoconiosis complicated in patients with moderate to severe stable COPD

目的探讨小容量肺灌洗对煤工尘肺合并稳定期中重度慢性阻塞性肺疾病(COPD)的疗效及对炎性因子的影响。方法选取2011年6月—2014年6月我院收治的煤工尘肺合并稳定期中重度COPD患者84例,将其随机分为观察组51例、对照组33例,对照组患者采取常规治疗,观察组患者在常规治疗的基础上使用小容量肺灌洗治疗。观察治疗1个月后2组患者的临床疗效,比较2组患者治疗前后肺功能、血清白介素6(IL-6)、转化生长团子β1(TGF-β1)以及肿瘤坏死因子α(TNF-α)水平。结果观察组患者治疗后总有效率为90.20%,对照组患者治疗后总有效率为72.73%,2组比较差异具有统计学意义(P<0.05);治疗前、治疗后2组患者肺功能比较,差异均无统计意义(P>0.05),治疗前后组内比较,2组患者肺功能均无显著变化(P>0.05);治疗前,2组患者血清IL-6、TGF-β1以及TNF-α水平均无显著差异(P>0.05),治疗后,2组患者各血清炎性因子水平均较治疗前显著降低(P<0.05),且观察组患者血清炎性因子水平显著低于对照组(P<0.05)。结论小容量肺灌洗治疗煤工尘肺合并稳定期中重度COPD具有显著的临床疗效,并且能够显著降低患者血清IL-6、TGF-β1、TNF-α水平,但是对于患者的肺功能无明显改善作用。

Objective To investigate the lung lavage in pneumoconiosis combined with stable moderate to severe chronic obstructive pulmonary disease （COPD） the curative effect and the effect on inflammatory factors. Methods the coal workers＇ pneumoconiosis combined with stable from 2011 June -2014 year in June in our hospital 84 cases of patients with moderate to severe COPD,were randomly divided into the observation group 51 cases, control group 33 cases, control group were treated by conventional treatment, the observation group of patients with small volume lung lavage in the treatment on the basis of conventional treatment, the observation after 1 months of treatment, the clinical efficacy of the two groups, two groups were compared before and after treatment, pulmonary function, serum IL-6, TGF- beta 1 and alpha level of TNF-a. Results the patients in the observation group after treatment, the total effective rate was 90.20%, the control group after treatment the total effective rate was 72.73%, comparing the two groups, a statistically significant difference （P〈0.05） ; pulmonary function were compared between the two groups before treatment, after treatment, the difference was not statistically significant（P〉0.05）, treatment after the experiment, two groups of patients with pulmonary function showed no significant change （P〉0.05） ;before the treatment, there were no significant differences between the two groups of patients with serum IL-6, TGF- β 1 and TNF- α （P〉0.05）, after treatment, the serum level of inflammatory factors in patients of two groups were significandy lower than those before treatment （P〈0.05） after the treatment, and the observation group serum inflammatory factors in patients with significantly lower than the control group （P〈0.05）.Conclusion small volume lung lavage for treatment of pneumoconiosis combined with stable moderate to severe COPD has significant clinical efficacy, and can significantly decrease the serum IL-6, TGF- in patients with beta 1 ,TNF- levels, but to the pulmonary function in patients with no obvious improvement.