吡非尼酮联合N-乙酰半胱氨酸对具自身免疫特征的间质性肺炎的疗效及对细胞因子的影响  

Effect of Pirfenidone Combined with N-acetylcysteine on Interstitial Pneumonia with Autoimmune Characteristics and its Effect on Cytokines

作　　者：梁丽萍[1] LIANG Li-ping(Department of Respiratory Medicine,Jiangmen Central Hospital,Jiangmen,Guangdong Province,529030China)

机构地区：[1]江门市中心医院呼吸内科,广东江门529030

出　　处：《中外医疗》2020年第22期122-124,共3页China & Foreign Medical Treatment

摘　　要：目的探究吡非尼酮联合N-乙酰半胱氨酸治疗具自身免疫特征的间质性肺炎的临床疗效及其对患者细胞因子的影响。方法方便选择2016年3月-2019年9月在该院就诊的46例具自身免疫特征的间质性肺炎患者为研究对象,根据治疗方案不同将其分为两组,其中,对照组20例患者采用常规治疗方案,研究组26例患者在常规治疗的基础上加用吡非尼酮治疗,疗程为6个月,比较两组临床疗效及治疗前后血清细胞因子变化水平。结果研究组临床总有效率92.31%,较对照组的70.00%显著升高,差异有统计学意义(χ^2=3.916,P=0.048)。治疗前,两组患者的血清细胞因子IL-4、TNF-α、IFNγ水平比较差异无统计学意义(P>0.05),但经治疗后,研究组患者的血清IL-4水平明显高于对照组,TNF-α、IFNγ水平较对照组显著降低,差异有统计学意义(P<0.05)。治疗后,研究组患者的临床评分、胸部影像学评分、生理评分均明显低于对照组,差异有统计学意义(P<0.05)。结论吡非尼酮联合N-乙酰半胱氨酸治疗具自身免疫特征的间质性肺炎效果显著,能够有效减轻患者的临床症状,调节相关细胞因子水平,有助于延缓病情进展。Objective To explore the effect of pirfenidone combined with N-acetylcysteine in the treatment of interstitial pneumonia with autoimmune characteristics and its effect on patients’cytokines.Methods From March 2016 to September2019,46 patients with interstitial pneumonia with autoimmune characteristics in the hospital were conveniently selected as research subjects,and they were divided into 2 groups according to different treatment schemes.20 patients in the control group were treated with conventional treatment schemes.26 patients in the study group were treated with pirfenidone in addition to conventional treatment.The clinical efficacy and the changes of serum cytokines before and after treatment were compared between the two groups.Results The total clinical effective rate in the study group was 92.31%,which was significantly higher than the control group’s 70.00%,the difference was statistically significant(χ^2=3.916,P=0.048).Before treatment,there were no statistically significant difference in serum cytokine IL-4,TNF-αand IFNγlevels between the two groups of patients(P>0.05),but after treatment,the serum IL-4 levels in the study group were significantly higher tha control group,and the levels of TNF-αand IFNγwere significantly lower than control group,the difference was statistically significant(P<0.05).After treatment,the clinical scores,chest imaging scores and physiological scores of the study group were significantly lower than control group,the difference was statistically significant(P<0.05).Conclusion Pirfenidone combined with N-acetylcysteine has a significant effect on the treatment of interstitial pneumonia with autoimmune characteristics,which can effectively reduce the clinical symptoms of patients,regulate the levels of related cytokines and delay the progression.

关 键 词：间质性肺炎 自身免疫特征 吡非尼酮 N-乙酰半胱氨酸 

分 类 号：R563[医药卫生—呼吸系统]