Objective To observe the effect of thalidomide on the expressions of IL-6, TNF-a and TGF-β1 in bronchoalveolar lavage fluid (BALF) of elderly patients with idiopathic pulmonary fibrosis (1PF) so as to explore the mechanism of its treating IPF combined with clinical indicators. Methods Enzyme-linked immunosorbent assay (ELISA) was used to check the expressions of IL-6, TNF-a and TGF-β1 in BALF before treatment as well as 12 weeks and 24 weeks after treatment on 25 elderly IPF patients treated with thalidomide and prednisone. At the same time, we detected the changes before treatment, 24 weeks after treatment in chest HRCT and pulmonary function, and compared them with those of other 20 elderly IPF patients treated only with prednisone. Results Compared to the same group before treatment and the control group, the expressions of IL-6, TNF-α and TGF-β1 in BALF of patients in thalidomide group significantly decreased (P<0.05), and the pulmonary function significantly improved after 12 weeks and 24 weeks of treatment. For patients in the control group, the expressions of IL-6, TNF-α and TGF-β1 in BALF had no significant decrease (P>0.05) after 12 weeks and 24 weeks of treatment compared to the same before treatment, and the pulmonary function had no significant improvement (P>0. 05) compared to the same before treatment. The total effective treatment rate in thalidomide group and the control group was 68% and 30%, respectively; the total absorption rate of chest HRCT was 84% and 35%, respectively. Both groups showed significant differences (P<0.05). Conclusion Thalidomide lowers the expressions of IL-6, TNF-a and TGF-β1 in BALF of elderly patients with IPF, thus improving their pulmonary function and clinical symptoms and slowing down the development of the disease.%目的 观察沙利度胺对老年特发性肺纤维化(IPF)患者支气管肺泡灌洗液(BALF)中IL-6 、TNF-α、TGF-β1表达的影响,结合临床指标的变化探讨其治疗IPF的机制.方法 用酶联免疫吸附法检测25例沙利度胺联合强的松治疗前、治疗后12周和24周的老年IPF患者BALF中IL-6、TNF-α、TGF-β1的表达情况,同时检测治疗前、治疗后24周肺功能和胸部高分辨CT的变化情况,并与20例单独应用强的松的老年IPF患者进行对照.结果 沙利度胺组患者BALF中IL-6、TNF-α、TGF-β1的表达在治疗后12周、24周较本组治疗前及对照组明显下降(P＜0.05)、肺功能较本组治疗前及对照组明显改善(P＜0.05);对照组患者BALF中IL-6、TNF-α、TGF-β1的表达在治疗后12周、24周较治疗前无明显下降(P＞0.05)、肺功能较治疗前无明显改善(P＞0.05).沙利度胺组治疗总有效率68％、胸部HRCT总吸收率84％;对照组治疗总有效率30％、胸部HRCT总吸收率35％,两组差异有统计学意义(P＜0.05).结论 沙利度胺可能是通过降低老年IPF患者BALF中IL-6、TNF-α、TGFβ1的表达,改善患者肺功能及临床症状,延缓了病程进展.
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