沙利度胺联合布地奈德雾化吸入对特发性肺纤维化患者血清HMGB1、CTGF表达的影响

Effects of thalidomide combined with budesonide inhalation on the expression of serum HMGB1 and CTGF in patients with idiopathic pulmonary fibrosis

目的研究沙利度胺联合布地奈德雾化吸入对特发性肺纤维化患者血清高迁移率族蛋白B1(HMGB1)、结缔组织生长因子(CTGF)表达的影响。方法选取2018年12月—2019年12月河北医科大学第二医院东院区呼吸内科治疗特发性肺纤维化患者100例,按照随机数字表法分为研究组和对照组,每组50例,所有患者均行常规干预治疗,对照组加用布地奈德雾化吸入,研究组以沙利度胺+布地奈德雾化吸入,2组均治疗3个月,治疗后比较2组患者临床疗效,治疗前后血清HMGB1、CTGF表达及肺功能、肺纤维化、炎性因子相关指标、临床—影像—生理(CRP)评分,并观察不良反应发生情况。结果治疗3个月后,研究组总有效率高于对照组(96.00%vs.64.00%,χ^(2)/P=16.000/0.001);2组患者血清HMGB1、CTGF明显低于治疗前,且研究组均低于对照组(t/P=18.200/0.001,12.290/0.001);2组第1秒用力呼气量(FEV_(1))、用力肺活量(FCV)及FEV_(1)/FCV高于治疗前,且研究组高于对照组(t/P=8.889/0.001,7.771/0.001,3.834/0.001);2组Ⅲ型前胶原(Ⅲ-C)、透明质酸(HA)、层粘连蛋白(LN)、CRP评分低于治疗前,且研究组低于对照组(t/P=8.446/0.001,6.575/0.001,7.508/0.001,16.080/0.001);2组血清TNF-α、IL-8、IL-6明显低于治疗前,且研究组低于对照组(t/P=8.496/0.001,19.920/0.001,5.572/0.001)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论应用沙利度胺+布地奈德雾化吸入治疗特发性肺纤维化,可有效改善患者血清HMGB1、CTGF表达水平,降低炎性反应,提高肺功能,临床效果较好。

Objective To study the effect of thalidomide combined with budesonide inhalation on the expressions of serum high mobility group box B1(HMGB1)and connective tissue growth factor(CTGF)in patients with idiopathic pulmonary fibrosis.Methods A total of 100 patients with idiopathic pulmonary fibrosis treated in the Department of Respiratory Medicine of the East Hospital of the Second Hospital of Hebei Medical University from December 2018 to December 2019 were selected and divided into a study group and a control group according to the random number table method,with 50 cases in each group.All patients were treated with routine intervention.The control group was treated with budesonide inhalation,while the study group was treated with thalidomide+budesonide inhalation.Both groups were treated for 3 months.Adverse reactions were compared between the two groups after treatment.and clinical efficacy,serum HMGB1,CTGF expression,pulmonary function,pulmonary fibrosis,inflammatory factor-related indicators,CRP score before and after treatment.Results After 3 months of treatment,the total effective rate of the study group was higher than that of the control group(96.00%vs.64.00%,χ^(2)/P=16.000/0.001);the serum HMGB1 and CTGF of the two groups were significantly lower than those before treatment,and the study group was lower In the control group(t/P=18.200/0.001,12.290/0.001);FEV_(1),FCV,FEV_(1)/FCV in the two groups were higher than before treatment,and the study group was higher than the control group(t/P=8.889/0.001,7.771/0.001,3.834/0.001);the scores of III-C,HA,LN and CRP in the two groups were lower than those before treatment,and the study group was lower than the control group(t/P=8.446/0.001,6.575/0.001,7.508/0.001,16.080/0.001);serum TNF-α,IL-8 and IL-6 in both groups were significantly lower than those before treatment,and the study group was lower than the control group(t/P=8.496/0.001,19.920/0.001,5.572/0.001).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The application of thalidomide+budesonide atomization inhalation in the treatment of idiopathic pulmonary fibrosis can effectively improve the expression levels of serum HMGB1 and CTGF,reduce inflammatory response,and improve lung function,with good clinical effect.