吡非尼酮联合常规内科治疗在慢性阻塞性肺疾病继发肺间质纤维化病变的临床效果分析  

Clinical Effect of Pirfenidone Combined with Conventional Medical Treatment in Patients with Pulmonary Interstitial Fibrosis Secondary to Chronic Obstructive Pulmonary Disease

作　　者：魏桂莲[1] 崔彩云 张泽丽 马小军[1] 侯占鑫 WEI Guilian;CUI Caiyun;ZHANG Zeli;MA Xiaojun;HOU Zhanxin(Datong Fifth People’s Hospital,Datong 037000,China;不详)

机构地区：[1]大同市第五人民医院,山西大同037000

出　　处：《中外医学研究》2022年第32期1-6,共6页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：大同市重点研发计划项目(2002075)。

摘　　要：目的:分析吡非尼酮联合常规内科治疗在慢性阻塞性肺疾病继发肺间质纤维化病变的临床效果。方法:选择2020年12月-2021年5月因继发肺间质纤维化就诊于大同市第五人民医院的慢阻肺患者80例为研究对象。依据随机数字表法将其分为对照组(n=40)与试验组(n=40)。对照组给予常规内科治疗,试验组在对照组用药方法基础上使用吡非尼酮。对比两组治疗前后的肺纤维化因子指标[还原型烟酰胺嘌呤二核苷酸磷酸氧化酶4(NOX4)、转化生长因子-β_(1)(TGF-β_(1))]、肺功能指标[第1秒用力呼气容积(FEV_(1))、肺一氧化碳弥散功能水平(DLCO)、FEV_(1)占用力肺活量的百分比(FEV_(1)%)]、血气分析指标[酸碱度(pH值)、血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))]、炎症反应因子指标[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]。对比两组的治疗效果和治疗过程中的不良反应情况。结果:治疗前,两组肺纤维化因子指标、肺功能指标、血气分析指标、炎症反应因子指标比较,差异均无统计学意义(P>0.05);治疗后,两组TGF-β_(1)、NOX4、pH值、PaCO_(2)、IL-6、TNF-α较治疗前均降低,FEV_(1)、DLCO、FEV_(1)%、PaO_(2)较治疗前均升高,且试验组均优于对照组,差异均有统计学意义(P<0.05)。试验组治疗总有效率高于对照组(P<0.05)。两组治疗过程中不良反应发生率比较,差异无统计学意义(P>0.05)。结论:在慢阻肺继发肺间质纤维化的治疗过程中,利用吡非尼酮配合常规治疗药物,可以有效地改善纤维化因子、炎症反应因子水平,改善肺功能和血气指标,提升整体治疗效果,具有良好的安全性。Objective:To analyze the clinical effect of Pirfenidone combined with conventional medical treatment in chronic obstructive pulmonary disease(COPD)with pulmonary interstitial fibrosis.Method:A total of 80 patients with COPD in Datong Fifth People’s Hospital from December 2020 to May 2021 due to secondary pulmonary interstitial fibrosis were selected as the research objects.The patients were divided into the control group(n=40)and the experimental group(n=40)according to the method of random number table.The control group was given routine medical treatment,and the experimental group was given Pirfenidone on the basis of the medication method of the control group.The indexes of pulmonary fibrosis factors[reduced nicotinamide purine dinucleotide phosphate oxidase 4(NOX4),transforming growth factor-β_(1)(TGF-β_(1))],pulmonary function indicators[forced expiratory volume in the first second(FEV_(1)),pulmonary carbon monoxide diffusion function level(DLCO),FEV_(1) of forced vital capacity(FEV_(1)%)],blood gas analysis indexes[pH value,partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2))],inflammatory response factor indicators[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]before and after treatment were compared between the two groups.The therapeutic effects and adverse reactions of the two groups were compared.Result:Before treatment,there were no significant differences between two groups in the indexes of pulmonary fibrosis factor,pulmonary function,blood gas analysis and inflammatory response factors(P>0.05);after treatment,the TGF-β_(1),NOX4,pH value,PaCO_(2),IL-6,TNF-α of two groups were lower than those before treatment,FEV_(1),DLCO,FEV_(1)%,PaO_(2) were higher than those before treatment,and the experimental group were better than those of the control group,the differences were statistically significant(P<0.05).The total effective rate of the experimental group was higher than that of the control group(P<0.05).There was no significant difference in the incidence of adve

关 键 词：吡非尼酮 慢性阻塞性肺疾病 肺间质纤维化 炎症反应 肺泡壁 病理性损伤 

分 类 号：R563.9[医药卫生—呼吸系统]