| 周晓丹,冀国发,蔡婷婷,叶新丽,高学飞.吡非尼酮联合乙酰半胱氨酸治疗IPF患者的疗效及机制分析[J].,2021,(6):1064-1068 |
| 吡非尼酮联合乙酰半胱氨酸治疗IPF患者的疗效及机制分析 |
| Efficacy and Mechanism of Pirfenidone Combined with Acetylcysteine in the Treatment of Patients with IPF |
| 投稿时间：2020-08-03 修订日期：2020-08-27 |
| DOI：10.13241/j.cnki.pmb.2021.06.014 |
| 中文关键词: 吡非尼酮 乙酰半胱氨酸 特发性肺纤维化(IPF) 疗效 作用机制 |
| 英文关键词: Pirfenidone Acetylcysteine Idiopathic pulmonary fibrosis (IPF) Curative effect Mechanism |
| 基金项目:陕西省自然科学基础研究计划项目(2017JQ8027) |
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| 中文摘要: |
| 摘要 目的：探讨吡非尼酮联合乙酰半胱氨酸治疗特发性肺纤维化(idiopathic pulmonary fibrosis，IPF)患者的疗效及可能机制。方法：选择2018年1月至2020年1月我院收治的78例IPF患者，根据随机数字表法将其分为观察组(38例)及对照组(40例)。对照组患者给予吡非尼酮，观察组给予吡非尼酮联合乙酰半胱氨酸，对比两组患者的治疗效果、治疗前及治疗后1 d的肺功能指标、血清肺纤维化指标、肿瘤坏死因子、转移生长因子β-1水平的变化及不良反应的发生情况。结果：治疗后，与对照组相比，观察组治疗有效率明显升高(P<0.05)。治疗后，两组弥散量、用力肺活量、第一秒用力呼气容积均较治疗前明显升高，且观察组以上指标均明显高于对照组高(P<0.05)。治疗后，两组的透明质酸、层粘蛋白、Ⅲ型胶原、Ⅲ型前胶原、尿素氮、血清肿瘤坏死因子、转移生长因子β-1及基质金属蛋白酶-9水平均较治疗前明显降低，观察组以上指标均明显低于对照组低(P<0.05)。观察组不良反应发生率为26.32 %，对照组为30.00 %，组间对比差异无统计学意义(P>0.05)。结论：与单独应用吡非尼酮相比，吡非尼酮联合乙酰半胱氨酸可提高IPF患者的治疗效果，可能与其可改善患者的炎症因子水平有关。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the efficacy and possible mechanism of pirfenidone combined with acetylcysteine in the treatment of patients with idiopathic pulmonary fibrosis (IPF). Methods: Seventy-eight IPF patients from January 2018 to January 2020 in our hospital were chosen and divided into the observation group (38 cases) and control group (40 cases) according to the random number table method. The control group was given pirfenidone, and the observation group was given pirfenidone combined with acetylcysteine. The treatment efficacy, lung function indexes, serum pulmonary fibrosis indexes, serum tumor necrosis factors, metastatic growth factor β-1, cytokine level and adverse reactions incidence were compared between two groups before and after treatment. Results: After treatment, compared with the control group, the treatment efficiency of observation group was significantly increased(P<0.05), the diffusion volume, forced vital capacity, and forced expiratory volume in the first second of the two groups were significantly higher than before treatment, and the above indicators in the observation group were significantly higher than those in the control group(P<0.05). After treatment, the levels of hyaluronic acid, laminin, type Ⅲ collagen, type Ⅲ procollagen, urea nitrogen, serum tumor necrosis factor, metastatic growth factor β-1 and matrix metalloproteinase-9 of the two groups were significantly lower than before treatment, and the above indicators in the observation group was significantly higher than that of the control group (P<0.05). The incidence of adverse reactions was 26.32 % in the observation group, and 30.00 % in the control group. There was no statistically significant difference between the groups(P>0.05). Conclusion: Compared with pirfenidone alone, pirfenidone combined with acetylcysteine could improve the treatment effect of IPF patients, which may be related to the improvement of the level of inflammatory factors in patients. |
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