丝裂霉素C在介入治疗结核性中心气道瘢痕狭窄中的作用  

Role of mitomycin C in interventional therapy for tuberculous cicatricial stenosis of the central airway

作　　者：方琼[1] 郑闽莉[1] 李映文[1] 马志明[1] 谢艺开[1] 陈品儒[1] 汤春梅[1] 张言斌[1] 

机构地区：[1]广州市胸科医院,510095

出　　处：《实用医学杂志》2015年第11期1829-1831,共3页The Journal of Practical Medicine

基　　金：广东省科技厅计划项目(编号:2013B021800077);广州市卫生局项目(编号:20121A011085)

摘　　要：目的:探讨应用支气管镜局部喷洒丝裂霉素C(MMC)在治疗结核性中心气道瘢痕狭窄中的临床疗效。方法:将结核性中心气道瘢痕狭窄患者45例随机分为对照组(14例)、治疗1组(15例)和治疗2组(16例),分别进行常规球囊扩张、常规球囊扩张加局部喷洒1次MMC和2次MMC治疗,以治疗前、治疗结束时及治疗后3、6、12个月的MRC评分和气道直径为指标考察其临床疗效。结果:(1)各观察时间点的MRC评分:治疗后3个月治疗2组(0.06±0.25)与治疗1组(0.33±0.617)MRC评分均显著低于对照组(0.57±0.756)(均P<0.05)。其他各时间点3组MRC评分差异均无显著性。(2)各观察时间点的气道直径:治疗后3、6个月治疗2组气道平均直径显著大于对照组与治疗1组(P<0.01,P<0.05);治疗后12个月治疗2组气道平均直径显著大于治疗1组(P<0.05)。其他各时间点3组气道平均直径差异均无显著性(P>0.05)。结论:球囊扩张术时局部喷洒MMC对改善结核性气道瘢痕狭窄患者呼吸困难症状、维持扩张后气道直径方面具有一定的近、远期临床疗效。Objective To investigate the clinical efficacy of bronchoscopic MMC topical spraying for the treatment of tuberculous cicatricial stenosis of the central airway. Methods 45 patients with t tuberculous cicatricial stenosis of the central airway were randomly divided into a control group （14 patients）, treatment group 1 （greupl, 15 patients）, or treatment group 2 （group 2, 16 patients）, who received bronchial balloon dilatation alone, bronchial balloon dilatation combined with topical MMC spraying for one time, and for twice, respectively. The clinical efficacy was observed by using the MRC score and measuring airway diameter at the time points before treatment, end of treatment, and 3, 6, and 12 months after treatment, respectively. R^ults For the MRC scores at different time points, the MRC scores in group 2 （0.06 ~ 0.25） and group 1 （0.33 ＋ 0.617） were significantly lower than those in the control group at 3 months after treatment （P 〈 0.05 for all comparisons） ; there were nosignificant differences at the other time points among the three groups. For the airway mean diameters at the different time points, the airway mean diameter was higher in group 2 than in the control group at 3 and 6 months after treatment （P 〈 0.01）, and in group 1 at 3, 6, and 12 months （P 〈 0.05）. No statistical differences were found in the other time points among three groups （P 〉 0.05）. Conclusions Bronchial balloon dilatation combined with topical MMC spraying has certain short-term and long-term efficacy for improving dyspnea and maintaining the airway diameter after dilatation.

关 键 词：气道瘢痕狭窄/结核 丝裂霉素C 球囊扩张术 

分 类 号：R52[医药卫生—内科学]