CAJ | 학술논문

目的：观察吸入布地奈德联合口服乙酰半胱氨酸对特发性肺纤维化( IPF)的疗效及对细胞因子的影响。方法选取我科2007年1月至2012年12月住院 IPF患者60例,随机分为治疗组和对照组,每组30例。治疗组给予吸入布地奈德气雾剂400μg,每日4次,联合口服乙酰半胱氨酸600 mg,每日3次；对照组予口服强的松0．5 mg/( kg·d),4周后减量至0．25 mg/( kg·d),8周后0．125 mg/( kg·d)维持治疗。治疗前及治疗6个月后,观察两组的疗效和细胞因子水平。结果治疗后两组症状、肺功能指标、血气PaO2水平均较治疗前有所改善(P<0．05),其中,症状与血气 PaO2的改善程度,治疗组优于对照组(P <0．05)。两组治疗后γ干扰素(IFNγ)水平下降,白细胞介素-4(IL-4)水平增加,治疗组明显优于对照组(P<0．05)。结论吸入糖皮质激素联合口服乙酰半胱氨酸治疗IPF疗效良好,明显改善Thl/Th2失衡,可能会延缓甚至阻止IPF发生发展,提高综合疗效。
목적：관찰흡입포지내덕연합구복을선반광안산대특발성폐섬유화( IPF)적료효급대세포인자적영향。방법선취아과2007년1월지2012년12월주원 IPF환자60례,수궤분위치료조화대조조,매조30례。치료조급여흡입포지내덕기무제400μg,매일4차,연합구복을선반광안산600 mg,매일3차；대조조여구복강적송0．5 mg/( kg·d),4주후감량지0．25 mg/( kg·d),8주후0．125 mg/( kg·d)유지치료。치료전급치료6개월후,관찰량조적료효화세포인자수평。결과치료후량조증상、폐공능지표、혈기PaO2수평균교치료전유소개선(P<0．05),기중,증상여혈기 PaO2적개선정도,치료조우우대조조(P <0．05)。량조치료후γ간우소(IFNγ)수평하강,백세포개소-4(IL-4)수평증가,치료조명현우우대조조(P<0．05)。결론흡입당피질격소연합구복을선반광안산치료IPF료효량호,명현개선Thl/Th2실형,가능회연완심지조지IPF발생발전,제고종합료효。
Objective To evaluate the efficacy of inhaled budesonide combined with oral acetylcysteine on idi-opathic pulmonary fibrosis ( IPF) ,and its effect on serum cytokines′levels. Methods 60 patients with IPF in our hos-pital from January 2007 to December 2012 were randomly divided into the treatment group and the control group,30 cases in each group. Treatment group was treated with inhaled budesonide (400 μg,qid)in combination with oral ace-tylcysteine (600 mg,tid). Control group was treated with oral prednisone 0. 5 mg/(kg·d),which was reduced to 0. 25 <br> mg/(kg·d) 4 weeks later,and to 0. 125 mg/(kg·d) 8 weeks later for maintenance dose. Before treatment and 6 months after treatment,the therapeutic effect and the levels of IFNγand IL-4 were measured. Results After treatment, the symptoms,lung function and blood gas PaO2 were all improved (P<0. 05) in the two groups. Nevertheless,the treatment group was significantly better than the control group in improvement of symptoms and blood gas PaO2 ( P<0. 05). After treatment,the IFNγ level decreased and the IL-4 level increased in the two groups,but the changes were significantly obvious in the treatment group than those in the control group (P<0. 05). Conclusion Inhaled budes-onide combined with oral acetylcysteine has better clinical efficacy for IPF patients,and improves imbalance of Th1/Th2. This combined therapy may slow or prevent the occurrence and progression of IPF,and thus increase the compre-hensive curative effect.