| 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. |
