布地奈德吸入联合N-乙酰半胱氨酸治疗特发性肺纤维化

目的客观评价吸入性表面激素联合抗氧化剂治疗特发性肺纤维化（IPF）及口服激素治疗特发性肺纤维化这两种治疗方法的疗效及不良反应。方法 42例IPF进展期患者随机分为试验组和对照组,试验组给予布地奈德雾化吸入联合口服N-乙酰半胱氨酸治疗,对照组给予口服泼尼松治疗。对两组治疗前后进行呼吸困难评分,检测血气分析、肺功能及不良反应指标。结果两组对比治疗前各项检测指标均无差异（P〉0.05）。两组治疗后的呼吸困难评分、血气分析、肺功能的相关指标比治疗前均有所改善（P〈0.05）。试验组治疗后的呼吸困难评分、血气分析、肺功能的相关指标优于对照组（P〈0.01）。试验组治疗前后的不良反应指标无差异（P〉0.05）。对照组治疗后不良反应指标比治疗前明显（P〈0.05）。结论布地奈德雾化吸入联合口服N-乙酰半胱氨酸治疗IPF的疗效比口服泼尼松好,而不良反应发生明显降低。表面激素联合抗氧化剂对IPF进展期的治疗值得临床推广。

To treat the patients with idiopathic interstitial pulmonary fibrosis by using inhaled budesonide combined with oral N-acetylcystei

Objective To evaluate the treatment effects and adverse effects of inhaled glucocorticosteroids combined with antioxidant and oral glucocorticosteroids on the patients with idiopathic interstitial pulmonary fibrosis（IPF）.Methods 42 cases of IPF in progression were devided into experiment group（treated with inhaled nebulised budesonide combined with N-acetylcystei） and control group（treated with oral prednisone） randomly.Symptom of dyspnea was scrored,and blood gas analysis,lung function,indexes of adverse effects were tested for both groups,before and after treatment.Results There was no significant difference of all tested indexes in pre-treatment between both groups（P 0.05）.By comparison with pre-treatment,the dyspnea scores and related indexes of blood gas analysis,lung function,were improved in post-treatment of both groups（P 0.05）.That of experiment group was better than that of control group in posttreatment（P 0.01）.There was no significant difference between the indexes of adverse effects of pre-treatment and that of post-treatment（P 0.05）.That of control group was more significant in post-treatment than in pre-treatment（P 0.05）.Conclusion Treatment effect of inhaled nebulised budesonide combined with N-acetylcystei was better than that of oral glucocorticosteroids,but adverse effects lower.It was worth generalization in clinic that inhaled glucocorticosteroids combined with antioxidant treated IPF in progression.