激素联合环磷酰胺治疗皮肌炎合并肺间质纤维化的疗效评价

Efficacy Evaluation of Hormone Combined with Cyclophosphamide in the Treatment of Dermatomyositis Complicated with Pulmonary Interstitial Fibrosis

目的研究探讨激素联合环磷酰胺治疗皮肌炎合并肺间质纤维化的临床疗效。方法选择该院2016年1月—2018年9月就医且分别给予常规糖皮质激素治疗、糖皮质激素联合环磷酰胺治疗的皮肌炎合并肺间质纤维化患者各30例进行回顾性研究,设置为对照组、观察组,比较两组的临床疗效、血清心肌酶指标、免疫球蛋白指标、不良反应发生率。结果①观察组的总有效率为90.00%,高于对照组(χ^2=4.812,P<0.05)。②治疗后,观察组的天门冬氨酸氨基转移酶(AST)、肌酸激酶同工酶(CK-MB)、磷酸肌酸酶(CPK)、羟丁酸脱氢酶(HBDH)、乳酸脱氢酶(LDH)分别为(33.19±2.54)U/L、(32.93±12.76)U/L、(189.47±7.35)U/L、(276.73±10.85)U/L、(304.94±13.27)U/L,均低于对照组(t=4.167、4.688、4.123、5.316、4.680,P<0.05),其IgG、IgA、IgM分别为(9.97±1.50)g/L、(1.79±0.30)g/L、(2.20±0.43)g/L,均高于对照组(t=3.977、3.863、3.963,P<0.05),以上差异有统计学意义(P<0.05)。③组间不良反应总发生率比较,观察组、对照组分别为10.00%、6.67%,差异无统计学意义(χ^2=0.218,P>0.05)。结论环磷酰胺联合糖皮质激素用于皮肌炎合并肺间质纤维化治疗中,可有效提高患者的临床疗效,改善其血清心肌酶表达和免疫功能,还不会增加不良反应,具有良好的用药安全性。

Objective To investigate the clinical efficacy of hormone combined with cyclophosphamide in the treatment of dermatomyositis with pulmonary fibrosis.Methods A retrospective study was performed on 30 patients with dermatomyositis and pulmonary interstitial fibrosis treated with conventional glucocorticoid therapy and glucocorticoid combined with cyclophosphamide in our hospital from January 2016 to September 2018.The control group was set as the control group and the observation group.The clinical efficacy,serum myocardial enzyme index,immunoglobulin index and adverse reaction rate were compared between the two groups.Results 1.The total effective rate of the observation group was 90.00%,which was higher than that of the control group(χ^2=4.812,P<0.05).2.After treatment,the aspartate aminotransferase(AST),creatine kinase isoenzyme(CK-MB),phosphocreatine(CPK),hydroxybutyrate dehydrogenase(HBDH),Lactate dehydrogenase(LDH)was(33.19±2.54)U/L,(32.93±12.76)U/L,(189.47±7.35)U/L,(276.73±10.85)U/L,(304.94±13.27)U/L was lower than the control group(t=4.167,4.688,4.123,5.316,4.680,P<0.05),and the IgG,IgA,and IgM were(9.97±1.50)g/L and(1.79±0.30)g/L,(2.20±0.43)g/L,were higher than the control group(t=3.977,3.863,3.963,P<0.05),All of differents were statistically significant(P<0.05).3.The total incidence of adverse reactions between the groups was 10.00%and 6.67%in the observation group and the control group,respectively,and the difference was not statistically significant(χ^2=0.218,P>0.05).Conclusion Cyclophosphamide combined with glucocorticoids in the treatment of dermatomyositis complicated with pulmonary interstitial fibrosis can effectively improve the clinical efficacy of patients,improve their serum myocardial enzyme expression and immune function,and will not increase adverse reactions,with better medication safety.