肺气肿对特发性肺间质纤维化患者临床治疗的影响

Effect of emphysema on clinical treatment of idiopathic pulmonary interstitial fibrosis

目的:分析合并肺气肿对特发性肺间质纤维化(IPF)患者的临床疗效与预后是否存在影响。方法:收集2018年4月~2020年10月40例IPF合并肺气肿的患者和40例单纯IPF患者的临床资料进行回顾性研究,两组患者均予以呼吸科常规对症支持治疗2个月,对比分析两组患者治疗前后的肺功能,包括肺活量(VC)、肺总量(TLC)、第1秒用力呼气量占所有呼气量的比值(FEV1/FVC)、动脉血氧分压(PaO_(2))、一氧化碳弥散量(DLCO)以及两组患者的临床疗效,并通过随访对比两组患者的生存时间、生存质量。结果:经过治疗,两组患者的VC、TLC、FEV1/FVC、DLCO、PaO_(2)水平均较治疗前提高,差异均具有统计学意义(P<0.05);治疗后两组患者组间VC、TLC、FEV1/FVC比较,差异有统计学意义(P<0.05);DLCO、PaO_(2)比较,则差异无统计学意义(P>0.05)。经过治疗,观察组和对照组的临床总有效率分别为80.00%、82.50%,差异无统计学意义(P>0.05)。通过随访发现,两组患者生活质量、生存时间、死亡例数比较,差异无统计学意义(P>0.05)。结论:合并肺气肿仅对患者肺容积造成影响,对患者的临床疗效、生存时间、生活质量和预后未见明显影响。

Objective To analyze the clinical efficacy and prognosis of patients with idiopathic pulmonary interstitial fibrosis(IPF)with emphysema.Method From April 2018 to October 2020,40 cases of IPF with emphysema and 40 cases of simple IPF were collected for retrospective study,Both groups were treated with routine symptomatic support in respiratory department for 2 months.The lung function of the two groups before and after treatment,including vital capacity(VC),total lung capacity(TLC),ratio of forced expiratory volume to all expiratory volume in the first second(FEV1/FVC),partial pressure of oxygen(PaO_(2)),carbon monoxide dispersion(DLCO),and clinical efficacy in both groups.The survival time and quality of life of the two groups were compared by follow-up.Results After treatment,both groups had higher VC、TLC、FEV1/FVC、DLCO、PaO_(2)levels than before,statistical analysis,the two groups of patients compared with each other before treatment,All the differences were statistically significant(P<0.05);After treatment,the comparison between the two groups suggested that,VC、TLC、FEV1/FVC comparison(P<0.05);DLCO、PaO_(2)comparison,But the difference was not statistically significant(P>0.05).After treatment,The total clinical effective rate of observation group and control group was 80.00%and 82.50%respectively,the difference was not significant(P>0.05).Through follow-up,comparison of quality of life,survival time and death cases between the two groups,the difference was not significant(P>0.05).Conclusion Complicated emphysema only affects the lung volume of patients,there was no significant effect on the clinical efficacy,survival time,quality of life and prognosis of the patients.