N-乙酰半胱氨酸联合醋酸泼尼松治疗特发性肺间质纤维化的效果及对肺功能的影响

Efficacy of N-acetylcysteine combined with prednisone acetate on idiopathic pulmonary interstitial fibrosis and its effect on pulmonary function

目的研究N-乙酰半胱氨酸联合醋酸泼尼松治疗特发性肺间质纤维化(IPF)的效果及对肺功能的影响。方法选取我院2017年6月至2018年4月收治的78例IPF患者为研究对象,采用随机数字法将其分为对照组与观察组,每组39例。对照组单纯给予醋酸泼尼松片治疗,观察组给予N-乙酰半胱氨酸、醋酸泼尼松片治疗,比较两组患者的临床疗效及治疗前、后肺功能。结果观察组患者的治疗总有效率为94.87%,显著高于对照组的69.23%(P<0.05);治疗后,观察组患者的VC%pred、FVC%pred、DLCO/VA%pred、FEV1%pred均高于对照组及治疗前(P<0.01);治疗后,观察组患者的磨玻璃影、网格影、小叶间隔增厚、蜂窝影占比均低于治疗前,且磨玻璃影占比明显低于对照组(P<0.05);两组患者的PaO2、PaCO2、6min步行距离均改善(P<0.01),但组间比较,差异无统计学意义(P>0.05)。结论N-乙酰半胱氨酸联合醋酸泼尼松治疗IPF患者的临床效果显著,可明显促进肺功能恢复,改善患者肺部纤维化,值得在临床推广。

Objective To study the efficacy of N-acetylcysteine combined with prednisone acetate on idiopathic pulmonary interstitial fibrosis (IPF) and its effect on pulmonary function.Methods A total of 78 patients with IPF admitted in our hospital from June 2017 to April 2018 were selected as study objects and randomly divided into control group and observation group, with 39 cases in each group.The control group was given prednisone acetate tablets alone, and the observation group was treated with N-acetylcysteine and prednisone acetate tablets.The clinical efficacy and pulmonary function before and after treatment of the two groups were compared.Results The total effective rate of treatment in the observation group was 94.87%, which was significantly higher than 69.23% in the control group (P<0.05).After treatment, the VC%pred, FVC% pred, DLCO/VA%pred and FEV1%pred of the observation group were significantly higher than those of the control group and before treatment (P<0.01).After treatment, the percentages of ground glass shadow, grid shadow, interlobular septal thickening and honeycomb shadow of the observation group were significantly lower than those before treatment, and the percentage of ground glass shadow was significatly lower than that of the control group (P<0.05);the PaO2, PaCO2 and 6-minute walking distance in both groups improved (P<0.01), but there were no significant differences between the two groups (P>0.05).Conclusion The N-acetylcysteine combined with prednisone acetate in the treatment of IPF has significant clinical efficacy.It can significantly promote the recovery of lung function and improve the pulmonary fibrosis of patients, which is worthy of clinical promotion.