龙启忠,杜娟,张先明,马文,桂坤
LONG Qizhong,DU Juan,ZHANG Xianming,MA Wen,GUI Kun (Department of Respiratory Medicine

• 1:贵阳医学院附院呼吸内科

摘要(Abstract)：

目的:探讨干扰素-γ、N-乙酰半胱氨酸及小剂量强的松联合治疗特发性肺纤维化的疗效。方法:将31例特发性肺纤维化患者随机分成A、B、C三组,A组单用小剂量强的松治疗,B组给予干扰素-γ加小剂量强的松治疗,C组给予干扰素-γ,N-乙酰半胱氨酸及小剂量强的松联合治疗;分别于治疗前,治疗第4周、12周及24周测FVC、FEV1/FVC、MVV、TLC及PaO2,并分析其变化。结果:治疗前后FEV1/FVC、MVV实测值/预计值在三组均没有统计学差异,FVC实测值/预计值、TLC实测值/预计值及PaO2三组各组组内比较,在治疗前后A组没有统计学差异,B组和C组治疗后较治疗前有统计学差异(P<0.05),尤其C组明显;C组与A、B组比较,FVC实测值/预计值、TLC实测值/预计值及PaO2升高,有明显统计学差异(P<0.05)。结论:干扰素-γ、N-乙酰半胱氨酸及小剂量强的松联合治疗特发性间质性肺炎能够在一定程度上改善患者肺功能。
Objective: To explore the curative effect of combination of interferon-γ(IFN-γ),N-acetylcysteine and small dosage prednisone on idiopathic pulmonary interstitial fibrosis(IPF).Methods: Thirty one patients with IPF were randomly divided into three groups.Patients in groups A,B,C were treated with low dose prednisone only,low dose prednisone plus IFN-γ,and low dose prednisone plus IFN-γ and N-acetylcysteine respectively.Forced vital capacity(FVC),forced respiratory volume in one second /FVC(FEV1/FVC),maximal vital volume(MVV),total lung capacity(TLC) and PaO2 were detected before treatment and in 4,12,and 24 weeks after treatment.The changes were analyzed.Results: No significant difference was found in FEV1/FVC and measured value/predicting value of MVV before and after treatment in all the 3 groups.In group A,no significant difference was found in PaO2,measured value/ predicting value of FVC and TLC before and after treatment,but in group B and C,the differences were significant(P<0.05)and more obvious changes were found in group C.PaO2,measured value/ predicting value of FVC and TLC were higher in group C than those in other two groups,and the differences were significant(P<0.05).Conclusions: Combined use of IFN-γ,N-acetylcysteine and low dose prednisone in the treatment of IPF can ameliorate lung function of patients.

关键词(KeyWords)： 干扰素-γ;肺纤维化;糖皮质激素类
interferon-gamma;pulmonary;glucocorticoids

Abstract:

Keywords:

基金项目(Foundation): 贵州省省长专项资金项目[黔省专合字(2008)90号]

作者(Author): 龙启忠,杜娟,张先明,马文,桂坤
LONG Qizhong,DU Juan,ZHANG Xianming,MA Wen,GUI Kun (Department of Respiratory Medicine

DOI: 10.19367/j.cnki.1000-2707.2011.05.008

参考文献(References)：

• [1]Kim DS,Park JH,Park BK,et al.Acute exacerbation ofidiopathic pulmonary fibrosis:frequency and clinical fea-tures[J].Eur Respir J,2006(27):143-150.
• [2]American Thoracic Society/European Respiratory SocietyInternational Multidisciplinary Classification of the idio-pathic interstitial pneumonias[J].Am J Respir Crit CareMed,2002(165):277-304.
• [3]Raghu G.Idiopathic pulmonary fibrosis:treatment optionsin pursuit of evidence-based approaches[J].Eur RespirJ,2006(28):463-465.
• [4]中华医学会呼吸病学分会.特发性肺间质纤维化诊断和治疗指南(草案)[J].中华结核和呼吸杂志,2002(25):387-389.
• [5]Mapel DW,Samet JM,Coultas DB.Corticosteroids and thetreatment of idiopathic pulmonary fibrosis.Past,present,and future[J].Chest,1996(4):1 058-1 067.
• [6]Selman M,Thannickal VJ,Pardo A,et a1.Idiopathic pul-monary fibrosis:pathogenesis and therapeutic approaches[J].Drugs,2004(4):405-430.
• [7]Karla S,Utz JP,Ryu JH.Interferon-gamma 1B in the treat-ment of advanced idiopathic pulmonary fibrosis[J].Chest,2001(Supp1):S184.
• [8]Demedts M,Behr J.Idiopathic pulmonary fibrosis interna-tional group exploring N-acetycysteine I annual[J].NewEngl J Med,2005(353):2229-2242.
• [9]Antoniou KM,Nicholson AG,Dimadi M.Long-term clinicaleffects of interferon gamma-1b and colchicine in idiopathicpul-monary fibrosis[J].Eur Respir J,2006(28):496-504.

文章评论(Comment)：