阿奇霉素联合布地奈德雾化吸入治疗特发性肺间质纤维化临床疗效比较

目的 探讨阿奇霉素联合布地奈德雾化吸入治疗特发性肺间质纤维化(IPF)的临床疗效.方法 选取2013年5月至2016年5月北京市第六医院呼吸科收治的IPF患者82例,按照随机数表法分为治疗组和对照组,各41例.对照组在常规治疗基础上采用布地奈德雾化吸入,治疗组在对照组基础上口服阿奇霉素片,疗程3个月.观察两组患者临床疗效、动脉血氧分压(PaO2)、肺功能指标肺活量占预计值百分比(VC%pred)、1秒钟用力呼气容积占预计值百分比(FEV1%pred)、用力肺活量占预计值百分比(FEV1%pred)、单位肺泡容积的一氧化碳弥散量占预计值百分比(DLCO/VA%pred)和治疗期间发生肺感染情况.结果 对照组总有效率为73.2%,与观察组的87.8%比较差异无统计学意义(P>0.05);治疗后治疗组PaO2为(78.47±9.07)mmHg,对照组为(68.43±8.40)mmHg,治疗组显著优于对照组(P<0.05);治疗后对照组与治疗组肺功能参数比较,VC%pred(64.67±9.87)%vs(70.43±10.38)%]、FEV1%pred(62.87±10.32)%vs(66.19±13.58)%]、FVC%pred(66.42±9.34)%vs(73.54±12.48)%]、DLCO/VA%pred(72.90±9.74)%vs(80.47±12.46)%],两组差异均有统计学意义(P<0.05);治疗期间治疗组有48.8%的患者未发生肺部感染,而对照组为12.2%(P<0.05).结论 阿奇霉素联合布地奈德能明显改善IPF患者气血分析指标、肺功能以及预防肺感染发生,临床疗效确切且不良反应轻.

Clinical study of azithromycin combined with budesonide inhalation in the treatment of idiopathic pulmonary fibrosis

Objective To explore the clinical efficacy of azithromycin combined with budesonide inhalation in the treatment of idiopathic pulmonary fibrosis (IPF). Methods A total of 82 patients with IPF, who admitted to Depart-ment of Respiratory Medicine of Beijing No.6 Hospital from May 2013 to May 2016, were selected and divided into the treatment group and the control group according to random number tables, with 41 patients in each group. On the basis of routine treatment, the control group was treated with budesonide inhalation, and the treatment group was treat-ed with azithromycin tablets combined with budesonide inhalation, for 3 months. The clinical efficacy, the ratio of arte-rial oxygen pressure (PaO2), lung capacity to the predicted value (VC%pred), forced expiratory volume in 1 second as the expected percentage (FEV1%pred), forced vital capacity estimated percentage (FVC%pred), percent carbon monox-ide depletion in unit alveolar volume as a percentage of predicted value (DLCO/VA%pred) and pulmonary infection during treatment were compared. Results For the total effective rate, no significant differences were observed:73.2%in the control group versus 87.8%in the treatment group (P=0.095). After the treatment, PaO2 in the treatment group was (78.47 ± 9.07) mmHg versus (68.43 ± 8.40) mmHg in the control group (P=0.000);the levels of VC%pred, FEV1%pred, FVC%pred, DLCO/VA%pred in the treatment group were (64.67±9.87)%, (62.87±10.32)%, (66.42±9.34)%, and (72.90± 9.74)%, respectively, versus (70.43 ± 10.38)%, (66.19 ± 13.58)%, (73.54 ± 12.48)%, (80.47 ± 12.46)%in the control group (all P<0.05). During the treatment, the rate of none pulmonary infection in the control group was 12.2%(n=5), which was significantly lower than 48.8%(n=20) in the treatment group (P=0.000). Conclusion Azithromycin combined with budesonide significantly can improve the blood pressure analysis indicators, lung function and the incidence of pulmo-nary infection in patients with IPF, which has certain clinical efficacy and mild adverse reactions.