吡非尼酮治疗特发性肺纤维化急性加重期对患者肺功能及预后的影响

The effect of pirfenidone on pulmonary function and prognosis in the patients with acute exacerbation of idiopathic pulmonary fibrosis

目的探究吡非尼酮治疗特发性肺纤维化急性加重期(AE-IPF)对患者肺功能及预后的影响。方法回顾性分析2016年6月~2018年12月我科收治的52例AE-IPF患者的临床资料,根据其治疗方案不同进行分组,对照组(n=22)采用常规方法治疗,观察组(n=30)应用常规治疗方案+吡非尼酮。统计并比较治疗前后两组患者肺功能、呼吸困难UCSD-SOBQ评分变化情况以及临床治疗结局。结果观察组患者3个月生存率为56.67%,较对照组的27.27%要高(P<0.05)。治疗前,两组患者的肺功能(TLC、FVC、DLCO)、UCSD-SOBQ评分比较差异无统计学意义(P>0.05),但治疗3个月后,两组患者的上述各项指标均有改善,但观察组的改善幅度显著优于对照组(P<0.05)。追踪12个月,观察组二次AE发生率11.76%,较对照组的66.67%显著降低(P<0.05)。结论常规方案联合吡非尼酮治疗特发性肺纤维化急性加重期效果显著,能够有效改善患者的呼吸功能和临床症状,减少再次急性加重发生,利于改善患者预后。

Objective To probe into the effect of pirfenidone(PFD)on pulmonary function and prognosis in the patients with acute exacerbation of idiopathic pulmonary fibrosis(AE-IPF).Methods The clinical data of 52 patients with AE-IPF admitted to and treated in our department from June 2016 to December 2018 were retrospectively analyzed,and they were divided into groups according to different therapeutic regimens.The control group(n=22)was treated with conventional methods,while the observation group(n=30)was treated with conventional therapeutic regimen plus PFD.The changes of pulmonary function and UCSD-SOBQ scores of dyspnea as well as clinical treatment outcome of the two groups before and after treatment were counted and compared.Results The survival rate of 3 m of the patients in the observation group was 56.67%,which was higher than the 27.27%in the control group(P<0.05).Before treatment,there was no statistically significant difference in pulmonary function(TLC,FVC and DLCO)and UCSD-SOBQ scores between the two groups of patients(P>0.05).However,after 3 m of treatment,the above indexes of the two groups were ameliorated,and the amelioration of the observation group was significantly greater than that of the control group(P<0.05).After 12 m of follow-up,the incidence of second-time AE in the observation group was 11.76%,significantly lower than the 66.67%in the control group(P<0.05).Conclusion Conventional regimen combined with PFD has significant effect on the treatment of AE-IPF,which can effectively ameliorate the respiratory function and clinical symptoms of the patients and reduce the re-occurrence of acute exacerbation.It is good for the improvement of the prognosis for the patients.