CAJ | 학술논문

目的：观察环磷酰胺联合泼尼松治疗特发性间质性肺炎的临床效果。方法将90例门诊患者按随机数字表方法随机分为三组。环磷酰胺组：口服环磷酰胺，初始剂量25~50 mg/ d，每7~12天增加25 mg，直至最大日剂量150 mg/ d。泼尼松组：给予泼尼松，0.5 mg/（kg·d），用药4周后，减量至0.25 mg/（kg·d），持续4周，继续减量至0.125或0.25 mg/（kg·d），隔日1次口服。环磷酰胺和泼尼松联合组：口服环磷酰胺，开始时25~50 mg/ d，每7~12 d 增加25 mg，直至最大日剂量150 mg/ d。口服泼尼松，0.5 mg/（kg·d），持续4周，继续减量至0.125或0.25 mg/（kg·d），隔日1次口服。12周为一疗程，观测各组动脉血氧分压（PaO2）和肺活量变化及临床-影像-生理评分（CRP 评分）。结果各组动脉血氧分压及肺活量均有显著变化（ P ﹤0.05），CRP 评分均明显降低（ P ﹤0.05），且联合组改善效果明显优于环磷酰胺组、泼尼松组两组，且降低了不良反应发生率。结论采用环磷酰胺联合泼尼松治疗特发性间质性肺炎，能明显改善患者的血氧分压和肺活量变化，同时可明显降低临床-生理-影响评分，优于单纯应用糖皮质激素或免疫抑制剂，且不良反应少，值得推广。
목적：관찰배린선알연합발니송치료특발성간질성폐염적림상효과。방법장90례문진환자안수궤수자표방법수궤분위삼조。배린선알조：구복배린선알，초시제량25~50 mg/ d，매7~12천증가25 mg，직지최대일제량150 mg/ d。발니송조：급여발니송，0.5 mg/（kg·d），용약4주후，감량지0.25 mg/（kg·d），지속4주，계속감량지0.125혹0.25 mg/（kg·d），격일1차구복。배린선알화발니송연합조：구복배린선알，개시시25~50 mg/ d，매7~12 d 증가25 mg，직지최대일제량150 mg/ d。구복발니송，0.5 mg/（kg·d），지속4주，계속감량지0.125혹0.25 mg/（kg·d），격일1차구복。12주위일료정，관측각조동맥혈양분압（PaO2）화폐활량변화급림상-영상-생리평분（CRP 평분）。결과각조동맥혈양분압급폐활량균유현저변화（ P ﹤0.05），CRP 평분균명현강저（ P ﹤0.05），차연합조개선효과명현우우배린선알조、발니송조량조，차강저료불량반응발생솔。결론채용배린선알연합발니송치료특발성간질성폐염，능명현개선환자적혈양분압화폐활량변화，동시가명현강저림상-생리-영향평분，우우단순응용당피질격소혹면역억제제，차불량반응소，치득추엄。
Objective To observe the treatment effect of cyclophosphamide combined with prednisone for idiopathic interstitial pneumoni-a. Methods Using the random parallel method,90 clinic patients were divided randomly into three groups according to random number table method. Cyclophosphamide group(group A):at first,took 20 ~ 50 mg/ kg orally,increased 25 mg every 7 ~ 12 days,until the taking dose of 150 mg/ day. Prednisone(Group B):took prednisone orally at the dose of 0. 5 mg/ kg,for 4 weeks,then 0. 25 mg/ kg for 4 weeks,and then 0. 125 mg/ kg or 0. 25 mg/ kg each two days. Cyclophosphamide combined with prednisone(Group C):at first ,took 20 ~ 50 mg/ kg orally,increased 25 mg every 7 ~ 12 days,until take the dose of 150 mg/ d;took prednisone orally at the dose of 0. 5 mg/ kg,for 4 weeks,then 0. 25 mg/ kg for 4 weeks,and then 0. 125 mg/ kg or 0. 25 mg/ kg each two days. 12 weeks as a treatment,then judge the curative effects including arterial partial pressure of oxygen(PaO2 )and vital capacity(VC),the score of CRP. Results Arterial oxygen partial pressure and lung capacity in each group were significant changed( P ﹤ 0. 05). The CRP scores were significantly lower( P ﹤ 0. 05),and group C treatment is better than A,B groups. Conclusion Cyclophosphamide combined with prednisone therapy for idiopathic interstitial pneumonia is more effective.