气泵雾化吸入普米克令舒治疗特发性肺间质纤维化

目的探讨气泵雾化吸入普米克令舒治疗特发性肺间质纤维化（IPF）的临床疗效。方法将72例特发性肺间质纤维化患者随机分为三组,各24例,A组普米克令舒2ml（含布地奈德1mg）气泵雾化吸入,每日2次;B组吸入普通普米克气雾剂,每次4喷,2次/d;C组每天口服强的松1mg/kg,4周后减半量维持,疗程均为3个月。观察三组患者的临床表现、肺CT、血气、肺功能改变及副作用。结果治疗后,临床表现缓解率为A组70.8%、B组25%、C组50%,A组与B组比较差异有显著性意义（P〈0.0125）,A组与C组比较差异无显著性意义（P〉0.0125）;肺CT改善率为A组66.7%、B组29.2%、C组45.8%,A组与B组比较差异有显著性意义（P〈0.0125）,A组与C组比较差异无显著性意义（P〉0.0125）;A组和C组患者PaO2、VC%、DLCO%提高（P〈0.05）,但两组间比较差异无显著性意义（P〉0.05）,B组PaO2、VC%、DLCO%也有提高,与治疗前比较差异无显著性意义（P〉0.05）。副作用发生率为A组8.3%、B组8.3%、C组58.3%,A组与C组比较差异有显著性意义（P〈0.0125）。结论气泵雾化吸入普米克令舒代替口服用药治疗特发性肺间质纤维化副作用少且临床疗效确切。

Effect of Air Compressor Pump Atomizing Inhalation with Pulmicort Respules on Idiopathic Pulmonary Fibrosis

Objective To investigate the clinical effect of air compressor pump atomizing inhalation with pulmicort respules on idiopathic pulmonary fibrosis (IPF).Methods72 IPF patients were randomly divided into there groups with 24 cases in each group. The group A was treated with pulmicort respules suspension by air compressor pump atomizing inhalation, 1 mg each time, twice each day; the group B with pulmicort aerosol, 4 puffs each time, twice each day and the group C with prednisone, 1 mg/kg each day, reduce half of the dosage 4 week later. The clinical manifestation, pulmonary function testing, high-resolution CT of the chest, arterial blood gas analysis and side effects were observed before and 3 months after treatment.ResultsAfter treatment, the improvement rate of symptoms was 70.8% in group A, 25% in group B and 50% in group C, with a significant difference between group A and group B ( P<0.0125), but no difference between group A and group C ( P>0.0125). The improvement rate showed by lung CT was 66.7% in group A, 29.2% in group B and 45.8% in group C, with a significant difference between group A and group B ( P<0.0125), but no difference between group A and group C ( P>0.0125). PaO2, VC% and DLCO% of the patients in group A and group C improved with no difference between two groups ( P>0.05). Those indexes of the group B also improved but no significant difference compared with that before treatment ( P>0.05). The incidence rate of side effect was 8.3% in group A, 8.3% in group B and 58.3% in group C with a significant difference between group A and group C ( P<0.0125).ConclusionAir compressor pump atomizing inhalation with pulmicort respules is effective in the treatment of IPF and has few side effects.