吡非尼酮对老年病毒性肺炎后肺纤维化患者肺功能及六分钟步行距离的影响  

Effects of pirfenidone on pulmonary function and 6-minute walking distance in elderly patients with pulmonary fibrosis after viral pneumonia

作　　者：赵云峰[1] 张诚实 刘明 秦二云 张青 冯契靓 程炜炜 Zhao Yunfeng;Zhang Chengshi;Liu Ming;Qin Eryun;Zhang Qing;Feng Qiliang;Cheng Weiwei(Department of Respiratory Disease,Punan Hospital,Pudong New District,Shanghai,200125,P.R.China;Department of Respiratory Disease,Yangsi Hospital,Shanghai,200126,P.R.China)

机构地区：[1]上海市浦东新区浦南医院呼吸科,上海200125 [2]上海杨思医院呼吸科,上海200126

出　　处：《老年医学与保健》2025年第1期170-173,共4页Geriatrics & Health Care

基　　金：上海市浦东新区科委课题(PKJ2023-Y89);上海市浦东新区卫生系统重点学科建设(PWZxk2022-24);上海市浦东新区高峰高原学科临床医学新质专科建设(2025-PWXZ-06)。

摘　　要：目的探讨吡非尼酮对病毒性肺炎后肺纤维化老年患者的肺功能及6分钟步行距离(6MWD)的影响。方法2023年1月—2023年5月从浦东新区浦南医院及上海杨思医院的呼吸科病房中筛选出70例老年病毒性肺炎后出现肺纤维化患者,采用随机数字表法分为2组:观察组和对照组,每组35例。观察组患者口服吡非尼酮,对照组患者口服乙酰半胱氨酸,疗程6个月。开始治疗时、6个月后测定并比较2组患者肺功能及6MWD,并进行相关性分析。结果开始治疗时,2组患者FEV1、FEV1占预计值%、FVC、FVC占预计值%、一氧化碳弥散量、6MWD差异均无统计学意义(均P>0.05);治疗6个月后,2组6项指标值差异均有统计学意义(均P<0.05)。与治疗前比较,观察组治疗6个月后6项指标差异均有统计学意义(均P<0.05),提示相关症状有改善;而对照组仅在一氧化碳弥散量和6MWD差异均有统计学意义(均P<0.05)。2组患者治疗时、治疗6个月后,6MWD与FEV1、FEV1占预计值%、FVC、FVC占预计值%、一氧化碳弥散量均呈正相关性(均P<0.05)。结论吡非尼酮可改善病毒性肺炎后肺纤维化老年患者的肺功能,延长6MWD。Objective To investigate the effects of pirfenidone on pulmonary function and 6-minute walking distance(6MWD)in elderly patients with pulmonary fibrosis after viral pneumonia.Methods From January 2023 to May 2023,70 elderly patients with pulmonary fibrosis after viral pneumonia were selected from the words of Department of Respiratory Disease of Punan Hospital and Yangsi Hospital.They were randomly divided into two groups by a random number table:observation group(n=35)and control group(n=35).The observation group received oral pirfenidone,while the control group received oral acetylcysteine.All patients were treated for 6 months.Pulmonary function and 6MWD were measured and compared between the two groups at the initiation of treatment and after 6 months of treatment.The correlation analysis was carried out.Results At the initiation of treatment,there were no statistically significant differences between the two groups in FEV 1,FEV 1%predicted,FVC,FVC%predicted,diffusing capacity for carbon monoxide(DLCO)and 6MWD(all P>0.05).After 6 months of treatment,significant differences were observed in all above six parameters between the two groups(all P<0.05).Compared to baseline,the observation group showed statistically significant improvements in all above six parameters after 6 months(all P<0.05),indicating symptom alleviation.In contrast,the control group only exhibited significant improvements in DLCO and 6MWD(both P<0.05).For both groups,6MWD was positively correlated with FEV 1,FEV 1%predicted,FVC,FVC%predicted and DLCO at baseline and after 6 months of treatment(all P<0.05).Conclusion Pirfenidone can improve lung function and prolong 6MWD in elderly patients with pulmonary fibrosis after viral pneumonia.

关 键 词：老年 病毒性肺炎 肺纤维化 吡非尼酮 肺功能 6分钟步行距离 

分 类 号：R563[医药卫生—呼吸系统]