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吡非尼酮治疗COPD并发肺纤维化的临床疗效观察
董燕,陈俊文,王业亚,阳俊,聂美玲,胡克
0
(湖北医药学院附属襄阳第一人民医院呼吸内科;武汉大学人民医院呼吸内科)
摘要:
【摘要】 目的 探讨吡非尼酮治疗慢性阻塞性肺疾病(COPD)并发肺纤维化的临床疗效及对肺功能、抗肺纤维化及炎症指标的影响。方法 选取襄阳第一人民医院2016年10月~2017年9月收治的96例COPD并发肺纤维化患者,随机分为对照组及观察组,每组各48例。对照组患者采用常规治疗,观察组采用吡非尼酮治疗。比较两组患者的临床疗效、肺功能、抗肺纤维化、炎症因子指标、生命质量及不良反应。结果 观察组临床总有效率明显高于对照组(P<0.05);治疗后两组抗肺纤维化指标转化生长因子β(TGFβ1)、还原型烟酰胺嘌呤二核苷酸磷酸氧化酶4(NOX4)、透明质酸(HA)、层粘连蛋白(LN)水平较治疗前均明显下降,且观察组下降幅度明显大于对照组(P<0.05);观察组治疗后白介素8(IL-8)、肿瘤坏死因子(TNFα)、白介素18(IL-18)水平下降幅度明显大于对照组(P<0.05);观察组治疗后FVC、FEV1、FEV1/FVC水平上升幅度明显大于对照组(P<0.05);两组患者治疗后呼吸症状、活动受限、疾病影响、SGRQ总分较治疗前均呈现明显下降趋势(P<0.05);治疗后,观察组患者呼吸症状、活动受限、疾病影响、SGRQ总分明显低于对照组(P<0.05)。两组患者治疗过程中均未出现严重不良反应。结论 吡非尼酮治疗COPD并发肺纤维化的临床疗效显著,可有效改善患者肺功能、抗肺纤维化及降低炎症指标,值得临床借鉴。
关键词:  慢性阻塞性肺疾病  吡非尼酮  肺纤维化  肺功能  炎症指标
DOI:
基金项目:湖北省科技厅自然科学基金面上项目
Clinical efficacy of pirfnidone in treatment of COPD complicated with pulmonary fibrosis and its effects on pulmonary function,anti pulmonary fibrosis and inflammatory markers
DONG Yan,CHEN Junwen,WANG Yeya,YANG Jun,NIE Meiling,HU Ke
(Deprtment of Respiratory Medicine, The First People's Hospital of Xiangyang;Deprtment of Respiratory Medicine, The People's Hospital of Wuhan University)
Abstract:
【Abstract】 Objective To investigate the clinical efficacy of pirfnidone in treatment of COPD complicated with pulmonary fibrosis and its effects on pulm pulmonary onary function, antifibrosis and inflammatory markers. Methods 96 COPD patients with pulmonary fibrosis treated in our hospital from September 2017 to October 2016 were selected. According to the random number table, 96 patients were divided into the control group and the observation group with 48 cases in each group. The patients in the control group were treated with routine treatment, while the observation group was treated with pirfidone. The clinical efficacy, pulmonary function, anti pulmonary fibrosis, inflammatory factors, quality of life and adverse reactions were compared between the two groups. Results The total clinical effective rate of the observation group was significantly higher than that of the control group (9583% vs 6041%)(P<0.05). The levels of NOX4 and TGFβ1 in the two groups were significantly lower than those before the treatment. The decrease of NOX4 and TGFβ1 levels in the observation group was significantly greater than that in the control group (P<0.05). After treatment, the HA and LN of two groups were decreased, and the level of HA and LN in the observation group was significantly lower than that of the control group (P<0.05). The level of IL8, TNFα and IL18 in the observation group after treatment were significantly greater than those in the control group(P<0.05). The level of FVC, FEV1 and FEV1/FVC in the observation group was significantly higher than that of the control group (P<0.05). The respiratory symptoms, limited activities, the influence of the disease and the total score of SGRQ in the two groups were significantly changed after treatment. After treatment, the respiratory symptoms, restriction of activity, the influence of the disease and the total score of SGRQ in the observation group were significantly lower than that of the control group (P<0.05). No serious adverse reactions were observed in the two groups during treatment. Conclusion Pifimidone is effective in the treatment of COPD with pulmonary fibrosis. It can effectively improve the pulmonary function, anti pulmonary fibrosis and inflammation.
Key words:  Chronic obstructive pulmonary disease  Pirfnidone  Pulmonary fibrosis  Clinical efficacy

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