N-乙酰半胱氨酸联合醋酸泼尼松治疗特发性肺间质纤维化的效果及对肺功能的影响
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摘要
目的研究N-乙酰半胱氨酸联合醋酸泼尼松治疗特发性肺间质纤维化(IPF)的效果及对肺功能的影响。方法选取我院2017年6月至2018年4月收治的78例IPF患者为研究对象,采用随机数字法将其分为对照组与观察组,每组39例。对照组单纯给予醋酸泼尼松片治疗,观察组给予N-乙酰半胱氨酸、醋酸泼尼松片治疗,比较两组患者的临床疗效及治疗前、后肺功能。结果观察组患者的治疗总有效率为94.87%,显著高于对照组的69.23%(P<0.05);治疗后,观察组患者的VC%pred、FVC%pred、DLCO/VA%pred、FEV1%pred均高于对照组及治疗前(P<0.01);治疗后,观察组患者的磨玻璃影、网格影、小叶间隔增厚、蜂窝影占比均低于治疗前,且磨玻璃影占比明显低于对照组(P<0.05);两组患者的PaO2、PaCO2、6 min步行距离均改善(P<0.01),但组间比较,差异无统计学意义(P>0.05)。结论 N-乙酰半胱氨酸联合醋酸泼尼松治疗IPF患者的临床效果显著,可明显促进肺功能恢复,改善患者肺部纤维化,值得在临床推广。
Objective To study the efficacy of N-acetylcysteine combined with prednisone acetate on idiopathic pulmonary interstitial fibrosis(IPF) and its effect on pulmonary function. Methods A total of 78 patients with IPF admitted in our hospital from June 2017 to April 2018 were selected as study objects and randomly divided into control group and observation group, with 39 cases in each group. The control group was given prednisone acetate tablets alone, and the observation group was treated with N-acetylcysteine and prednisone acetate tablets. The clinical efficacy and pulmonary function before and after treatment of the two groups were compared. Results The total effective rate of treatment in the observation group was 94.87%, which was significantly higher than 69.23% in the control group(P<0.05). After treatment, the VC%pred, FVC% pred, DLCO/VA%pred and FEV1%pred of the observation group were significantly higher than those of the control group and before treatment(P <0.01). After treatment, the percentages of ground glass shadow, grid shadow,interlobular septal thickening and honeycomb shadow of the observation group were significantly lower than those before treatment, and the percentage of ground glass shadow was significatly lower than that of the control group(P<0.05); the PaO2,PaCO2 and 6-minute walking distance in both groups improved(P<0.01), but there were no significant differences between the two groups(P>0.05). Conclusion The N-acetylcysteine combined with prednisone acetate in the treatment of IPF has significant clinical efficacy. It can significantly promote the recovery of lung function and improve the pulmonary fibrosis of patients, which is worthy of clinical promotion.
Objective To study the efficacy of N-acetylcysteine combined with prednisone acetate on idiopathic pulmonary interstitial fibrosis(IPF) and its effect on pulmonary function. Methods A total of 78 patients with IPF admitted in our hospital from June 2017 to April 2018 were selected as study objects and randomly divided into control group and observation group, with 39 cases in each group. The control group was given prednisone acetate tablets alone, and the observation group was treated with N-acetylcysteine and prednisone acetate tablets. The clinical efficacy and pulmonary function before and after treatment of the two groups were compared. Results The total effective rate of treatment in the observation group was 94.87%, which was significantly higher than 69.23% in the control group(P<0.05). After treatment, the VC%pred, FVC% pred, DLCO/VA%pred and FEV1%pred of the observation group were significantly higher than those of the control group and before treatment(P <0.01). After treatment, the percentages of ground glass shadow, grid shadow,interlobular septal thickening and honeycomb shadow of the observation group were significantly lower than those before treatment, and the percentage of ground glass shadow was significatly lower than that of the control group(P<0.05); the PaO2,PaCO2 and 6-minute walking distance in both groups improved(P<0.01), but there were no significant differences between the two groups(P>0.05). Conclusion The N-acetylcysteine combined with prednisone acetate in the treatment of IPF has significant clinical efficacy. It can significantly promote the recovery of lung function and improve the pulmonary fibrosis of patients, which is worthy of clinical promotion.
引文
[1]江洪艳,赵勇.特发性肺间质纤维化治疗研究进展[J].临床肺科杂志,2016,21(5):910-912.
[2]李娜,邵玉霞.特发性肺间质纤维化的治疗进展研究[J].临床肺科杂志,2016,21(5):917-920.
[3]杜昀泽,赵辉.特发性肺间质纤维化急性加重治疗新进展[J].国际呼吸杂志,2016,36(15):1192-1196.
[4]黄丹,曹瀚文.干扰素γ联合肝素对特发性肺间质纤维化患者肺功能指标及凝血功能的影响[J].医学综述,2016,22(21):4342-4344.
[5]陈利玲,黄江,唐燕.大剂量N-乙酰半胱氨酸改善特发性肺间质纤维化的机制研究[J].实用临床医药杂志,2016,20(23):154-155.
[6]胡蔓,王建青.通肺荡纤汤联合糖皮质激素治疗特发性肺间质纤维化疗效观察[J].现代中西医结合杂志,2017,26(9):1002-1005.
[7]田牛,王晓静,王伟,等.重组人干扰素-γ与泼尼松联用治疗特发性肺间质纤维化的应用价值探究[J].临床肺科杂志,2016,21(1):61-64.
[8]刘国田,蔡善花,崔蓉,等.N-乙酰半胱氨酸对特发性肺间质纤维化患者PDGF、TGF-β和VCAM-1水平及肺纤维化程度的影响[J].临床和实验医学杂志,2016,15(22):2232-2234.
[9]胡亚洁,赵晓锦,刘巍.肺痹汤联合阿奇霉素治疗特发性肺间质纤维化临床研究[J].山东中医杂志,2016,35(8):710-712.
[10]路政,法宪恩.N-乙酰半胱氨酸联合雾化吸入低分子肝素对特发性肺间质纤维化的疗效观察[J].广东医学,2016,37(23):3599-3601.
[11]刘莉君,孙昉昉.益气活血通络法治疗特发性肺间质纤维化疗效观察[J].陕西中医,2016,37(11):1474-1476.
[12]霍艳霞,王志华,李爱敏,等.缬沙坦联合泼尼松治疗特发性肺间质纤维化的临床观察[J].中国药房,2016,27(6):734-736.
[13]田素增.大剂量N-乙酰半胱氨酸治疗特发性肺间质纤维化的临床效果分析[J].实用心脑肺血管病杂志,2017,25(S2):48-49.
[2]李娜,邵玉霞.特发性肺间质纤维化的治疗进展研究[J].临床肺科杂志,2016,21(5):917-920.
[3]杜昀泽,赵辉.特发性肺间质纤维化急性加重治疗新进展[J].国际呼吸杂志,2016,36(15):1192-1196.
[4]黄丹,曹瀚文.干扰素γ联合肝素对特发性肺间质纤维化患者肺功能指标及凝血功能的影响[J].医学综述,2016,22(21):4342-4344.
[5]陈利玲,黄江,唐燕.大剂量N-乙酰半胱氨酸改善特发性肺间质纤维化的机制研究[J].实用临床医药杂志,2016,20(23):154-155.
[6]胡蔓,王建青.通肺荡纤汤联合糖皮质激素治疗特发性肺间质纤维化疗效观察[J].现代中西医结合杂志,2017,26(9):1002-1005.
[7]田牛,王晓静,王伟,等.重组人干扰素-γ与泼尼松联用治疗特发性肺间质纤维化的应用价值探究[J].临床肺科杂志,2016,21(1):61-64.
[8]刘国田,蔡善花,崔蓉,等.N-乙酰半胱氨酸对特发性肺间质纤维化患者PDGF、TGF-β和VCAM-1水平及肺纤维化程度的影响[J].临床和实验医学杂志,2016,15(22):2232-2234.
[9]胡亚洁,赵晓锦,刘巍.肺痹汤联合阿奇霉素治疗特发性肺间质纤维化临床研究[J].山东中医杂志,2016,35(8):710-712.
[10]路政,法宪恩.N-乙酰半胱氨酸联合雾化吸入低分子肝素对特发性肺间质纤维化的疗效观察[J].广东医学,2016,37(23):3599-3601.
[11]刘莉君,孙昉昉.益气活血通络法治疗特发性肺间质纤维化疗效观察[J].陕西中医,2016,37(11):1474-1476.
[12]霍艳霞,王志华,李爱敏,等.缬沙坦联合泼尼松治疗特发性肺间质纤维化的临床观察[J].中国药房,2016,27(6):734-736.
[13]田素增.大剂量N-乙酰半胱氨酸治疗特发性肺间质纤维化的临床效果分析[J].实用心脑肺血管病杂志,2017,25(S2):48-49.