CAJ | 학술논문

目的：评价吡非尼酮治疗特发性肺间质纤维化疗效。方法以“吡非尼酮”、“特发性肺间质纤维”、“pirfenidone”、“idiopathic pulmonary fibrosis”为关键词，检索PubMed、Cochrane图书馆、EMbase、中国知网、万方数据库，筛选吡非尼酮治疗特发性肺间质纤维化的随机对照试验，检索日期为1999年1月至2014年12月。干预措施为吡非尼酮与安慰剂对照比较。结局指标主要终点事件是肺活量的改变量或用力肺活量占预计值百分比变化值，次要终点事件为疾病无进展生存期。使用RevMan5.2软件进行Meta分析。结果共5项随机对照试验纳入Meta分析。与安慰剂组比较，用药组肺活量的改变量减小，差异有统计学意义[MD=0.08,95%CI(0.02,0.12)，P=0.00005]，吡非尼酮组肺活量下降幅度较少。用力肺活量占预计值百分比变化下降值，差异有统计学差异[OR=0.43，95%CI(0.28,0.64)，P＜0.00001]，吡非尼酮组发生用力肺活量占预计值百分比下降的幅度较小，是保护因素。疾病无进展生存期差异有统计学差异[HR=0.57,95%CI (0.39,0.85)，P＜0.0001]，吡非尼酮组可延缓特发性肺间质纤维化疾病进展，是保护因素。结论吡非尼酮能够延缓特发性肺间质纤维化患者肺功能下降，并且减缓疾病进展。
목적：평개필비니동치료특발성폐간질섬유화료효。방법이“필비니동”、“특발성폐간질섬유”、“pirfenidone”、“idiopathic pulmonary fibrosis”위관건사，검색PubMed、Cochrane도서관、EMbase、중국지망、만방수거고，사선필비니동치료특발성폐간질섬유화적수궤대조시험，검색일기위1999년1월지2014년12월。간예조시위필비니동여안위제대조비교。결국지표주요종점사건시폐활량적개변량혹용력폐활량점예계치백분비변화치，차요종점사건위질병무진전생존기。사용RevMan5.2연건진행Meta분석。결과공5항수궤대조시험납입Meta분석。여안위제조비교，용약조폐활량적개변량감소，차이유통계학의의[MD=0.08,95%CI(0.02,0.12)，P=0.00005]，필비니동조폐활량하강폭도교소。용력폐활량점예계치백분비변화하강치，차이유통계학차이[OR=0.43，95%CI(0.28,0.64)，P＜0.00001]，필비니동조발생용력폐활량점예계치백분비하강적폭도교소，시보호인소。질병무진전생존기차이유통계학차이[HR=0.57,95%CI (0.39,0.85)，P＜0.0001]，필비니동조가연완특발성폐간질섬유화질병진전，시보호인소。결론필비니동능구연완특발성폐간질섬유화환자폐공능하강，병차감완질병진전。
Objective To evaluate the efficacy of pirfenidone in the treatment of idiopathic pulmonary fibrosis. Methods To search in the databases of PubMed, Cochrane library, EMbase, China hownet(CNKI) and Wanfang database with keywords of "pirfenidone", "idiopathic pulmonary fibrosis", and select the randomized controlled trial (RCT) pirfenidone on treatment of idiopathic pulmonary fibrosis. The retrieval date from January 1999 to December 2014, the intervention measure was pirfenidone compared with placebo control. The primary end point events of the outcome indicators was the change of vital capacity(VC) or forced vital capacity of expected value percentage (FVC%), and the secondary end point events was the disease of progression-free survival(PFS). RevMan5.2 software was adopted to perform the Meta analysis.Results A total of five RCT were included in the meta-analysis. Compared with the placebo group, the variable of VC in the treatment group was reduced, the difference was statistically significant(MD = 0.08, 95% CI(0.02, 0.02),P=0.00005), the VC in pirfenidone group had relatively small decline. Between the two groups, the FVC% in predicted value had statistically significant difference(OR = 0.43, 95% CI(0.28, 0.64),P<0.00001), the declining range of FVC% in predicted value in pirfenidone group was lesser, which was the protected factor. The progression free survival(PBS) had statistically difference(HR = 0.57, 95% CI(0.39, 0.85),P<0.0001), pirfenidone could delay the disease progression of idiopathic pulmonary fibrosis and was the protected factor. Conclusions Pirfenidone could delay the decrease of lung function in patients with idiopathic pulmonary fibrosis, and slow down the disease progression at the same time.