| 申 严 卓宋明 庄 虹 李 娜 余海彬.小剂量阿奇霉素联合吸入布地奈德和 N- 乙酰半胱氨酸治疗特发性肺纤维化的临床疗效分析[J].,2015,15(5):905-908 |
| 小剂量阿奇霉素联合吸入布地奈德和 N- 乙酰半胱氨酸治疗特发性肺纤维化的临床疗效分析 |
| Analysis of the Clinical Effect of Small Dose Azithromycin Combined withInhalation of Budesonide and N-acetylcysteine on Idiopathic PulmonaryFibrosis |
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| DOI： |
| 中文关键词: 特发性肺纤维化 阿奇霉素 布地奈德 N- 乙酰半胱氨酸 肺功能 |
| 英文关键词: Idiopathic pulmonary fibrosis Azithromycin Budesonide N-acetylcysteine Lung function |
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| 中文摘要: |
| 目 的： 观察小剂量阿奇霉素联合吸入布地奈德和 N- 乙酰半胱氨酸对特发性肺纤维化(IPF)患者肺功能及支气管肺泡灌洗液
炎症因 子表达的影响。 方法： 随机将 56 例确诊为 IPF 的住院患者分为对照组和治疗 组，对照组给予常规治疗， 吸氧， 戒烟， 吸入布
地奈德及乙酰半胱氨酸； 治疗组在常规治疗 基础上加服小剂 量阿奇霉素片 。 动态观察两组患者治疗 3、6 个月 的疗 效及肺功能的
改善情况； 完成 2 个疗程(6 个月 )治疗后， 检测和比较两组支气管肺泡灌洗液相关炎症因 子水平的变化。 结果： 治疗 3 个月 时，两组
患者的动脉血氧分压(PO2)、肺活量(VC)、 1 秒钟用力呼气容积占 预计值百分比(FEV1 %pred)、最大通气量占 预计值百分比(MVV%
pred)、单位肺泡容积的一氧化碳弥散量占 预计值百分比(DLCO/VA% pred)均较治疗 前显著增加(P<0.05)； 治疗 6 个月 时， 治疗 组
的 有效率(20/26， 76.9%)明显高于对照组(14/30， 46.7%)， 且 PO2、VC、FEV1 %pred、 MVV%pred 及 DLCO/VA% pred 等肺功能指标
均显著高于对照组(P<0.05)；对照组支气管肺泡灌洗液 TNF-琢、 IL-8 浓度均较治疗 前降低(P<0.05)， IL-4、IL-10、 IFN-酌 浓度较治疗
前无明显变化；而治疗 组支气管肺泡灌洗液 TNF-琢、 IL-8、 IL-4、IL-10 浓度均较治疗 前降低， IFN-酌 浓度较治疗 前明显增加(P<0.
05)。 结论： 阿奇霉素联合吸入布地奈德和 N- 乙酰半胱氨酸可能通过改变支气管肺泡灌洗液 IFN-酌 等炎症因 子浓度有效改善 IPF
患者的肺功能。 |
| 英文摘要: |
| Objective:To observe the clinical effects of small dose azithromycin combined with inhalation of Budesonide and
N-acetylcysteine on cytokines of bronchoalveolar lavage fluid and lung function of patients with idiopathic pulmonary fibrosis (IPF).Methods:56 patients with IPF were randomly divided into two groups. The control group was only treated with general treatment, including oxygen uptaking, quitting smoking and inhaling Budesonide(2 mL/time,Tid) and N-acetylcysteine(3 mL/time, Tid), while the treatment
group was given azithromycin (250 mg, oral, qd) based on general treatment for 60 days. The curative effect and pulmonary function parameters such as PO2, forced vital capacity(VC), FEV1%pred, MVV% pred and DLCO/VA% pred of patients in the two groups were dynamically observed before and 3, 6 months after treatment, the related inflammatory cytokines concentration in bronchoalveolar lavage
fluid were deteced and compared before and 6 months after treatment.Results:After three months' treatment, the PO2, VC, FEV1% pred,
MVV% pred and DLCO/VA% pred of patients in both groups increased compared to those before treatment (P＜ 0.05). 6 months after
treatment, the efficiency of treatment group (20/26, 76.9%) was obviously higher than that of the control group (1 4/30, 46.7%). The PO2,
VC, FEV1 % pred, MVV% pred and DLCO/VA% pred of patients in the treatment group were higher than those in the control group
(P<0.05). The concentration of TNF-alpha and IL-8 in bronchoalveolar lavage fluid of patients in control group were significantly lower
(P<0.05), but IL-4, IL -1 0, IFN-r had no obvious changes compared to those before treatment, respectively. And the concentration of
TNF-alpha, IL -8, IL-4, IL-10 in the treatment group were reduced, the concentration of IFN-r increased significantly compared to those before treatment (P<0.05).Conclusion:Small dose Azithromycin combined with inhalation of Budesonide and N-acetylcysteine could improve the lung function of patients with IPF by changing the concentrations of related inflammatory cytokines such as TNF-alpha, IL -8, IL-4,
IL-1 0 and IFN-r inbronchoalveolar lavage fluid. |
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