环磷酰胺治疗特发性肺纤维化的疗效观察

发布时间：2018-12-09 11:03

【摘要】：目的:观察静脉注射环磷酰胺对特发性肺纤维化的治疗效果。方法:46名患者分为2组,对照组采用为期24个月的标准方案:泼尼松联合口服硫唑嘌呤治疗。观察组采用试验性治疗方案:口服泼尼松和静脉注射环磷酰胺(每月6次和每3个月6次)进行治疗。主要观察指标是36个月内的存活或不需要进行肺移植。次要指标是患者的最大肺活量,对一氧化碳弥散能力,以及在3、6、12、18、24、30、36个月中的基线动脉氧分压。结果:对照组有25名患者,观察组有21名患者,36个月内存活同时未进行移植的患者在对照组中为44%,在观察组中为76%(P=0.028)。而最大肺活量观察组(6.7%)与对照组(8.8%)无统计学差异(P=0.16)。对照组患者中一氧化碳弥散能力下降11.81%,而观察组患者下降4.4%(P=0.056 9)。动脉氧分压无显著性差异。结论:静脉注射环磷酰胺治疗显著提高了肺纤维化患者的存活率。但在肺功能参数和气体交换方面与标准方案没有显著差异。
[Abstract]:Objective: to observe the therapeutic effect of intravenous cyclophosphamide on idiopathic pulmonary fibrosis. Methods: 46 patients were divided into two groups. The control group was treated with prednisone combined with oral azathioprine for 24 months. The experimental treatment group was treated with oral prednisone and cyclophosphamide (6 times a month and 6 times every 3 months). The main outcome was survival within 36 months or no need for lung transplantation. The secondary indicators were the maximum vital capacity of the patient, the ability to diffuse carbon monoxide, and the baseline partial pressure of oxygen at the baseline of 30, 36 months. Results: there were 25 patients in the control group and 21 patients in the observation group. The number of patients who survived within 36 months without transplantation was 44% in the control group and 76% in the observation group (P0. 028). However, there was no significant difference between the observation group (6.7%) and the control group (8.8%) (P < 0.16). The diffusion ability of carbon monoxide was decreased by 11.81% in the control group and by 4.4% in the observation group (P < 0.056 9). There was no significant difference in arterial partial pressure of oxygen. Conclusion: intravenous cyclophosphamide treatment can significantly improve the survival rate of patients with pulmonary fibrosis. However, there was no significant difference in pulmonary function parameters and gas exchange with the standard protocol.
【作者单位】：唐山市工人医院呼吸科;
【分类号】：R563

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