银杏叶提取物及泼尼松对特发性肺间质纤维化患者肺泡灌洗液细胞因子水平和生化指标的影响

Ginkgo biloba extract and prednisone in patients with idiopathic pulmonary fibrosis alveolar lavage TNF alpha,IL-4,IL-10,the influence of IFN-gamma and biochemical indexes

目的研究银杏叶提取物及泼尼松对特发性肺间质纤维化患者肺泡灌洗液肿瘤坏死因子(TNF-α)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)、干扰素(IFN-γ)和生化指标的影响。方法选取2015年2月至2016年3月于该院接受治疗的特发性肺间质纤维化患者80例。根据随机数字表法分为观察组及对照组,每组各40例。对照组患者给予泼尼松治疗,观察组患者在对照组的基础上加用银杏叶提取物治疗。分别比较两组患者治疗前后肺泡灌洗液TNF-α、IL-4、IL-10、IFN-γ水平及生化指标透明质酸(HA)、Ⅲ型胶原(ColⅢ)、Ⅲ型前胶原(PCⅢ)、层黏蛋白(LN)水平,同时观察患者肺功能变化及感染发生情况。结果治疗后观察组患者肺泡灌洗液TNF-α、IL-4、IL-10水平均显著低于对照组,而IFN-γ水平显著高于对照组,差异有统计学意义(均P<0.05)。治疗后观察组患者HA、ColⅢ、PCⅢ、LN水平均显著低于对照组,差异有统计学意义(均P<0.05)。治疗后两组肺总量、肺活量、肺弥散功能均显著高于治疗前,组间对比差异无统计学意义(P>0.05)。观察组多次感染率为20.00%,显著低于对照组的65.00%,差异有统计学意义(P<0.05)。结论银杏叶提取物联合泼尼松治疗特发性肺间质纤维化可有效调节患者细胞免疫因子水平,改善肺纤维化程度,促进肺功能的恢复,降低感染发生率。

Objective To study the ginkgo biloba extract and prednisone in patients with idiopathic pulmonary fibrosis alveolar lavage TNF alpha,IL-4,IL-10,the influence of IFN-gamma and biochemical indexes.Methods Selected from February 2015 and March 2016,in our hospital for treatment of 80 patients with idiopathic pulmonary fibrosis. According to random number table method divided into observation group and control group each had 40 cases. Control group patients given prednisone treatment,on the basis of it the observation group of patients were treated with ginkgo biloba extract.Respectively to compare two groups before and after treatment in patients with alveolar lavage TNF alpha,IL-4,IL-10,IFN-gamma levels,biochemical index HA,Col Ⅲ,PC Ⅲ,LN levels,changes in lung function,and infections.Results The observation group of patients after treatment the alveolar lavage TNF alpha,IL-4,IL-10 levels were significantly lower than the control group,and IFN-gamma level is significantly higher than the control group（ P0.05）. Observation group of patients after treatment HA,Col Ⅲ,PC Ⅲ,LN levels were significantly lower than the control group（ P 0.05）.Two groups after treatment the total lung,lung capacity,pulmonary diffusion function were significantly higher than before the treatment,the contrast between the two groups is not obvious（ P 0.05）. Observation group repeated infection rate was20.00%（ 8/40）,significantly lower than control 65.00%（ 26/40）（ P0.05）.Conclusion Ginkgo biloba extract in combination with prednisone treatment of patients with idiopathic pulmonary fibrosis can effectively regulate cellular immune factor levels,improve the degree of pulmonary fibrosis,enhance the recovery of lung function,reduce the incidence of infection.