波生坦联合环磷酰胺治疗结缔组织病相关肺间质病临床研究  

Clinical Study of Bosentan Combined with Cyclophosphamide in the Treatment of Connective Tissue Disease-Associated Interstitial Lung Disease

作　　者：罗寰[1] 赵悦 陈苗苗[1] 任占芬[1] 杨金良[1] 郑学军[1] LUO Huan;ZHAO Yue;CHEN Miaomiao;REN Zhanfen;YANG Jinliang;ZHENG Xuejun(Department of Rheumatology and Immunology,The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei,China 075000)

机构地区：[1]河北北方学院附属第一医院风湿免疫科,河北张家口075000

出　　处：《中国药业》2022年第10期90-93,共4页China Pharmaceuticals

基　　金：河北省2020年度医学科学研究课题[20200513]。

摘　　要：目的探讨波生坦联合环磷酰胺治疗结缔组织病相关肺间质病(CTD-ILD)的临床疗效。方法选取医院2019年6月至2020年4月收治的CTD-ILD患者160例,按随机数字表法分为观察组和对照组,各80例。两组患者均给予注射用环磷酰胺静脉滴注,观察组患者加服波生坦片。两组患者均连续治疗4周。结果观察组总有效率为88.75%,显著高于对照组的76.25%(P<0.05);治疗后,观察组患者的动脉血氧分压、血氧饱和度水平均显著高于对照组,动脉血二氧化碳分压水平显著低于对照组(P<0.05);观察组患者的红细胞沉降率及肺表面活性蛋白A、肺表面活性蛋白D水平均显著低于对照组(P<0.05);观察组患者的高分辨率CT评分显著低于对照组,简明生活质量评价量表评分显著高于对照组(P<0.05);观察组与对照组不良反应发生率相当(13.75%比7.50%,P>0.05)。结论波生坦联合环磷酰胺治疗CTD-ILD,能改善患者的血气指标,降低血清学指标水平,并显著改善CT影像学表现和生活质量。Objective To investigate the clinical efficacy of bosentan combined with cyclophosphamide in the treatment of connective tissue disease-associated interstitial lung disease(CTD-ILD).Methods A total of 160 patients with CTD-ILD admitted to the hospital from June 2019 to April 2020 were selected and divided into the observation group and the control group according to the random number table method,with 80 cases in each group.The patients in the two groups were given Cyclophosphamide for Injection intravenously,on this basis,the patients in the observation group were given Bosentan Tablets.Both groups were treated continuously for four weeks.Results The total effective rate in the observation group was 88.75%,which was significantly higher than 76.25%in the control group(P<0.05).After treatment,the levels of arterial oxygen partial pressure(PaO2)and arterial oxygen saturation(SaO2)in the observation group were significantly higher than those in the control group,while the level of arterial partial pressure of carbon dioxide(PaCO2)in the observation group was significantly lower than that in the control group(P<0.05).The erythrocyte sedimentation rate(ESR),pulmonary surfactant protein A(SP-A)and pulmonary surfactant protein D(SP-D)in the observation group were significantly lower than those in the control group(P<0.05).The high-resolution CT(HRCT)score in the observation group was significantly lower than that in the control group,while the MOS 36-Item Short-Form Health Survey(SF-36)score in the observation group was significantly higher than that in the control group(P<0.05).The incidence of adverse reactions in the observation group was similar to that in the control group(13.75%vs.7.50%,P>0.05).Conclusion Bosentan combined with cyclophosphamide in the treatment of CTD-ILD can improve the blood gas index,reduce the level of serological indexes,and significantly improve the CT imaging performance and quality of life.

关 键 词：结缔组织病相关肺间质病 波生坦 环磷酰胺 血气指标 血清学指标 临床疗效 生活质量 

分 类 号：R969.4[医药卫生—药理学] R977[医药卫生—药学]