吡非尼酮治疗特发性肺纤维化患者的临床疗效及对肺功能的影响

Clinical effect of acetylcysteine effervescent tablets combined with pirfenidone in treatment of idiopathic pulmonary fibrosis and its effect on pulmonary function

目的研究吡非尼酮治疗特发性肺纤维化患者的临床疗效及对肺功能的影响。方法选择2015年3月至2016年6月我院呼吸内科收治的75例特发性肺纤维化患者,按随机数表法将患者分为观察组(38例)和对照组(37例),其中,观察组患者给药吡非尼酮进行治疗,对照组患者常规方法给药泼尼松进行治疗。比较两组患者治疗前后肺功能变化,肺活量、动脉氧分压的变化,TNF-α、IL-1表达情况,两组患者的生理评分及复发率。结果经相应治疗,两组患者治疗前后观测指标均有一定变化,观察组患者与治疗前相比具有统计学意义(P<0.05);观察组与对照组相比肺功能改善情况更好,且与治疗组相比具有较大差异,且差异具有统计学意义(P<0.05)。两组患者的CRP评分均有下降趋势,且观察组患者CRP评分下降的更明显。两组患者治疗后CRP评分下降具有较大差异,具有统计学意义(P<0.05)。对照组治疗前后TNF-α、IL-1表达情况变化不大,无明显统计学意义(P>0.05),观察组治疗后TNF-α、IL-1的表达均明显下降,差异均具有统计学意义(P<0.05),观察组与对照组相比,差异具有统计学意义(P<0.05)。治疗半年后随访,观察组患者复发率为5.26%,对照组患者复发率为27.03%,两组患者复发率具有较大差异,且具有统计学意义(P<0.05)。结论吡非尼酮治疗特发性肺纤维化患者效果更显著,对肺功能的改善有明显的促进作用,患者生活质量明显改善,治疗方案值得临床推广使用。

Objective To study the clinical efficacy of pirfenidone in the treatment of idiopathic pulmonary fibrosis and its effect on pulmonary function.Methods 75 patients with idiopathic pulmonary fibrosis were enrolled in our hospital from March 2015 to June 2016.The patients were divided into the observation group（38 cases） and the control group（37 cases）.The observation group was treated with pirfenidone and the control group was given conventional prednisone administration.The changes of lung function,vital capacity,arterial oxygen pressure,TNF-α and IL-1 expression were compared between the two groups before and after treatment,and the physiological score and recurrence rate of the two groups were compared.Results After treatment,the related indexes observed changed in the two groups,and the change was significant in the observation group（ P〈0.05）.Compared with the control group,the improvement of lung function in the observation group was better than that in the control group（ P〈0.05）.The CRP scores of both groups decreased,and the CRP score of the observation group decreased more obviously than that of the two groups.The scores of CRP in the two groups decreased significantly after treatment,with statistical significance（ P〈0.05）.The change in expression of TNF-α and IL-1 had no statistical significance before and after treatment（ P〉0.05）.The observation group after treatment,the expression of TNF-α and IL-1 were significantly decreased,and the difference was statistically significant（ P〈0.05）.After six months of treatment,the recurrence rate was 5.26% in the observation group and 27.03% in the control group（ P〈0.05）.Conclusion Pirfenidone has significant effect on the improvement of lung function in treatment of patients with idiopathic pulmonary fibrosis,which can promot the quality of life significantly with less adverse reactions.