吗替麦考酚酯与环磷酰胺治疗结缔组织病相关肺间质病变的价值分析  

The value of mycophenolate mofetil and cyclophosphamide in the treatment of connective tissue diseaserelated pulmonary interstitial lesions

作　　者：曹赛霞 CAO Sai-xia(Department of Rheumatology and Immunology,People's Hospital of Inner Mongolia Autonomous Region,Hohhot 010000,China)

机构地区：[1]内蒙古自治区人民医院风湿免疫科,010000

出　　处：《中国实用医药》2020年第35期105-107,共3页China Practical Medicine

摘　　要：目的研究分析吗替麦考酚酯(MMF)与环磷酰胺(CTX)在结缔组织病相关肺间质病变(CTD-ILD)治疗中的价值。方法 80例CTD-ILD患者,以随机数字表法分为对照组和实验组,每组40例。对照组患者采用激素+CTX治疗,实验组患者采用激素+MMF治疗。对比两组患者临床指标[血清肺表面活性蛋白D(SP-D)、肺表面活性蛋白A(SP-A)、红细胞沉降率(ESR)]、肺功能指标[肺一氧化碳弥散量占预计值百分比(DL-CO)、第1秒用力呼气容积占预计值百分比(FEV1%)、用力肺活量占预计值百分比(FVC%)]、不良反应发生情况。结果治疗后,实验组SP-D、SP-A、ESR水平分为(7.44±1.63)ng/L、(894.26±247.38)ng/L、(14.85±4.47)mm/h,均低于对照组的(9.51±2.37)ng/L、(1140.69±462.88)ng/L、(18.71±5.29)mm/h,差异具有统计学意义(P<0.05)。两组患者用药前和用药1年后DL-CO%、FEV1%、FVC%水平组间与组内对比,差异均无统计学意义(P>0.05)。两组患者不良反应发生率对比,差异无统计学意义(P>0.05)。结论 CTD-ILD患者采用MMF治疗的不良反应发生率和肺功能改善情况与CTX治疗无较大差异,但对于改善SP-D、SP-A、ESR的效果显著,值得推广。Objective To study and analyze the value of mycophenolate mofetil(MMF)and cyclophosphamide(CTX)in the treatment of connective tissue disease-related interstitial lung disease(CTD-ILD).Methods A total of 80 CTD-ILD patients were divided into control group and experimental group according to random numerical table,with 40 cases in each group.Patients in the control group were treated with hormones+CTX,and patients in the experimental group were treated with hormones+MMF.The clinical indicators[surfactant protein D(SP-D),surfactant protein A(SP-A),erythrocyte sedimentation rate(ESR)],pulmonary function indicators[diffusing capacity of the lung for carbon monoxide as a percentage of predicted value(DL-CO),forced expiratory volume in the first second as a percentage of predicted value(FEV1%),and forced vital capacity as a percentage of predicted value(FVC%)]and occurrence of adverse reactions were compared between the two groups.Results After treatment,the levels of SP-D,SP-A and ESR of the experimental group were(7.44±1.63)ng/L,(894.26±247.38)ng/L and(14.85±4.47)mm/h,which were lower than(9.51±2.37)ng/L,(1140.69±462.88)ng/L and(18.71±5.29)mm/h of the control group,and the difference was statistically significant(P<0.05).Before medication and 1 year after medication,there was no statistically significant difference in levels of DL-CO%,FEV1%and FVC%between the two groups(P>0.05).There was no statistically significant difference in incidence of adverse reactions between and within the two groups(P>0.05).Conclusion The incidence of adverse reactions and improvement of pulmonary function in patients with CTD-ILD treated with MMF are not significantly different from those of CTX treatment,but MMF treatment has significant effects on improving SP-D,SP-A and ESR and is worthy of promotion.

关 键 词：吗替麦考酚酯 环磷酰胺 结缔组织病相关肺间质病变 不良反应 

分 类 号：R593.2[医药卫生—内科学] R563[医药卫生—临床医学]