抗纤维化药物在结缔组织相关间质性肺炎中的应用价值与疗效评估  

The application value and efficacy evaluation of antifibrosis drugs in connective tissue-associated interstitial pneumonia

作　　者：张冰璐 欧阳松云[1] 代丽萍 陈瑞英[1] 赵春玲[1] ZHANG Bing-lu;OUYANG Song-yun;DAI Li-ping;CHEN Rui-ying;ZHAO Chun-ling(Department of Respiratory and Critical Sleep Medicine,First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China;Henan Institute of Pharmaceutical Sciences,Zhengzhou University,Zhengzhou,Henan 450052,China)

机构地区：[1]郑州大学第一附属医院呼吸与危重症睡眠医学科,河南郑州450052 [2]郑州大学河南省医药科学研究院,河南郑州450052

出　　处：《临床肺科杂志》2023年第5期663-667,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的研究抗纤维化药物在结缔组织相关间质性肺炎(CTD-ILD)的中的应用价值。方法将经过治疗的CTD-ILD的81名患者分为单纯抗结缔组织病(CTD)治疗组(单一治疗组)和抗结缔组织病联合抗纤维化治疗组(联合治疗组),回顾性分析两组用力肺活量(FVC)、FVC占预计值百分比(FVC%pred)、一氧化碳弥散量占预计值百分比(D_(L)CO%pred)、胸部CT评分、涎液化糖链抗原(KL-6)治疗6个月前后差异。结果与治疗前相比,单一治疗组治疗后血清KL-6升高,D_(L)CO%pred、FVC、FVC%pred和胸部CT评分无明显变化。联合治疗组治疗后血清KL-6、胸部CT评分降低,FVC、FVC%pred、D_(L)CO%pred均明显升高(P<0.05)。血清KL-6变化与D_(L)CO%pred变化均呈负相关(P<0.05);与胸部CT评分呈正相关(P<0.001)。结论CTD-ILD患者适当应用抗纤维化治疗有利于改善患者肺部病变。KL-6对于动态评估患者疗效、提示病情进展有重要意义。Objective To investigate the value of antifibrosis drugs in connective tissue-associated interstitial pneumonia(CTD-ILD).Methods A total of 81 patients with CTD-ILD were divided into the anti-CTD treatment group(monotherapy group)and anti-CTD combined with the antifibrosis treatment group(combination treatment group).The differences in forced vital capacity(FVC),predicted percentage of FVC(FVC%pred),carbon monoxide dispersion(D_(L)CO%pred),chest CT score,and salivary liquefied glycoantigen(KL-6)before and after 6 months of treatment between the two groups were analyzed retrospectively.Results Compared with before treatment,the serum KL-6 was increased in the monotherapy group,and there were no significant changes in D_(L)CO%pred,FVC,FVC%pred,and chest CT scores.In the combination treatment group,serum KL-6 and chest CT scores were decreased,while FVC,FVC%pred,and D_(L)CO%pred were significantly increased(P<0.05).The change of KL-6 was negatively correlated with D_(L)CO%pred(P<0.05),but was positively correlated with chest CT score(P<0.001).Conclusion Appropriate application of anti-fibrotic therapy in patients with CTD-ILD is conducive to improving the lung disease of CTD-ILD patients.KL-6 may be of great significance for the dynamic evaluation of patients′curative effect and an indication of disease progression.

关 键 词：抗纤维化药物 结缔组织相关间质性肺炎 涎液化糖链抗原(KL-6) 疗效 肺功能 

分 类 号：R563.13[医药卫生—呼吸系统]