首页> 中文期刊> 《中国药房》 >缬沙坦联合泼尼松治疗特发性肺间质纤维化的临床观察

缬沙坦联合泼尼松治疗特发性肺间质纤维化的临床观察

         

摘要

OBJECTIVE:To observe the efficacy and safety of valsartan combined with prednisone in the treatment of idiopath-ic pulmonary fibrosis. METHODS:50 patients with idiopathic pulmonary fibrosis were randomly divided into control group and ob-servation group. Control group was orally given 0.5 mg/(kg·d)Prednisone acetate tablet in 1-4 weeks,then maintained with 0.125 mg/(kg·d)in 5-12 neeks,2-3 times a day;observation group was additionally given 80 mg Valsartan capsule,orally,once a day. The treatment course for both groups was 6 months. Pulmonary function indicators [forced vital capacity(FVC),peak expiratory flow rate (PEFR),and forced expiratory volume in one second (FEV1)],serum inflammatory factor indicators [interleukin-13(IL-13), IL-18,transforming growth factor-β1(TGF-β1)] level,matrix metalloproteinase-9(MMP-9),MMP-2 contents and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P0.05);af-ter treatment,pulmonary function indicators in 2 groups were significantly higher than before,and observation group was higher than control group,MMP-9 and MMP-2 contents were significantly lower than before,and observation group was lower than con-trol group(P0.05). CONCLUSIONS:Valsartan combined with prednisone can significantly improve the pulmonary function of patients with idiopathic pulmonary fibrosis,and reduce the contents of serum inflammatory cytokines and matrix metalloproteinases,with good safety.%目的:观察缬沙坦联合泼尼松对特发性肺间质纤维化的疗效和安全性。方法:50例特发性肺间质纤维化患者随机均分为对照组和观察组。对照组患者给予醋酸泼尼松片1~4周0.5 mg/(kg·d),5~12周0.25 mg/(kg·d),后以0.125 mg/(kg·d)维持治疗,每日2~3次;观察组患者在对照组治疗的基础上给予缬沙坦胶囊80 mg,口服,每日1次。两组患者疗程均为6个月。观察两组患者的临床疗效,治疗前后肺功能指标[用力肺活量(FVC)、最大呼气峰流速(PEFR)、第一秒用力呼气容积(FEV1)]、血清炎症因子指标[白细胞介素(IL)-13、IL-18、转化生长因子(TGF)-β1]水平,基质金属蛋白酶(MMP)-9、MMP-2含量及不良反应发生情况。结果:观察组患者总有效率显著高于对照组,差异有统计学意义(P<0.05)。治疗前,两者患者肺功能指标、血清炎症因子指标、MMP-9、MMP-2含量比较,差异均无统计学意义(P>0.05);治疗后,两组患者肺功能指标均显著高于同组治疗前,且观察组高于对照组,血清炎症因子水平和MMP-9、MMP-2含量均显著低于同组治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:缬沙坦联合泼尼松可显著改善特发性肺间质纤维化患者肺功能,降低血清炎性因子及基质金属蛋白酶的含量,疗效显著,安全性较好。

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