CYC联合波生坦治疗结缔组织病相关肺间质病疗效及对血清KL-6、TIMP-1、TGF-β1水平的影响  

Efficacy of CYC combined with bosentan in the treatment of connective tissue diseaserelated interstitial lung disease and the effect on serum KL-6,TIMP-1 and TGF-β1 levels

作　　者：罗寰[1] 陈苗苗[1] 赵悦 任占芬[1] 杨金良[1] LUO Huan;CHEN Miaomiao;ZHAO Yue;REN Zhanfen;YANG Jinliang(Department of Rheumatology,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：《分子诊断与治疗杂志》2023年第1期128-131,140,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河北省医学科学研究课题计划(20200513)。

摘　　要：目的 探究环磷酰胺(CYC)联合波生坦治疗结缔组织病相关肺间质病(CTD-ILD)疗效及对血清涎液化糖链抗原-6(KL-6)、基质金属蛋白酶组抑制因子(TIMP-1)、转化生长因子β1(TGF-β1)水平的影响。方法 选择2019年5月至2021年5月河北北方医学院附属医院诊治的96例CTD-ILD患者为研究对象,随机分为两组,其中对照组(n=46)应用常规治疗,观察组(n=50)应用环磷酰胺联合波生坦治疗。比较两组总有效率、6分钟步行试验(6MWT)、高分辨率CT(HRCT)评分、肺功能指标:肺总量(TLC)、用力肺活量(FVC)、肺一氧化碳弥散量(DLCO)变化情况及血清相关指标:KL-6、TGF-β1、TIMP-1水平变化。结果 治疗后,观察组总有效率显著高于对照组,差异有统计学意义(P<0.05);治疗后,两组6分钟步行试验(6MWT)、高分辨率CT(HRCT)评分均低于治疗前,观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组FVC、TLC、DLCO均明显高于治疗前,观察组高于对照组,差异有统计学意义(P<0.05);治疗后,两组血清KL-6、TIMP-1、TGF-β1显著低于治疗前,观察组低于对照组,差异有统计学意义(P<0.05)。结论 环磷酰胺联合波生坦治疗CTD-ILD临床疗效满意且能显著降低患者的血清指标。Objective To investigate the efficacy of cyclophosphamide(CYC)combined with bosentan in the treatment of connective tissue disease-related interstitial lung disease(CTD-ILD),and the influence on serum Krebs von den Lungen-6(KL-6),tissue inhibitor of metalloproteinase(TIMP-1)and transforming growth factor beta 1(TGF-β1)levels. Methods A total of 96 patients with CTD-ILD who were diagnosed and treated in the Affiliated Hospital of Hebei Northern Medical College from May 2019 to May 2021 were selected as the research subjects,and randomly assigned to two groups. Patients in the control group(n=46)were given conventional treatment,and those in the observation group(n=50)were treated with CYC combined with bosentan. The total effective rate,6-minute walk test(6MWT),high-resolution CT(HRCT)score,pulmonary function indicators[total lung capacity(TLC),forced vital capacity(FVC)and diffusing lung capacity for carbon monoxide(DLCO)],and serum KL-6,TIMP-1 and TGF-β1 levels were compared between the groups.Results The total effective rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05). After treatment,6MWT scores and HRCT scores in the two groups decreased,and the observation group had lower scores than the control group. The differences were statistically significant(P<0.05). After treatment,FVC,TLC and DLCOin the two groups were increased,and these indicators in the observation group were higher than those in the control group. The differences were statistically significant(P<0.05). After treatment,serum KL-6,TIMP-1 and TGF-β1 levels in the two groups were decreased,and the levels in the observation group were significantly lower than those in the control group. The differences were statistically significant(P<0.05). Conclusion CYC combined with bosentan is effective in the treatment of CTD-ILD,which can significantly reduce serum indicators.

关 键 词：环磷酰胺 波生坦 结缔组织病 肺间质病 

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