摘要
目的观察泼尼松联合环磷酰胺(CTX)治疗系统性硬化病继发间质性肺疾病(SSc-ILD)的疗效,为临床治疗提供依据。方法选取20例初治SSc-ILD患者,根据胸部高分辨CT(HRCT)结果分为A组(早中期病变)12例和B组(晚期病变)8例,观察泼尼松联合CTX治疗前后两组临床指标、肺功能、HRCT和生活质量的变化。结果患者肺部感染发生率为50%。A组血红蛋白、血沉,B组血小板、血沉和C反应蛋白较治疗前明显改善(P均<0.05)。HRCT显示A组7例有吸收,2例进展;B组2例有吸收,4例进展。HRCT评分A组治疗后明显减少,B组变化不大。肺功能A组较B组明显改善(P均<0.05)。两组SGRQ活动分、影响分、总均分降低,B组活动分降低明显(P<0.05),SF-36量表A组生理职能(RP)、躯体疼痛(BP)、情感职能(RE)、精神健康得分明显增加,B组RP、BP、RE得分明显增加(P<0.05或<0.01)。结论激素联合CTX治疗后SSc-ILD患者易发生肺部感染,全身炎症状态、生活质量改善,大部分早中期患者肺部病灶吸收,FVC%稍好转,晚期患者肺部病灶较难吸收,肺功能下降。
Objective To investigate the therapeutic efficacy of interstitial lung disease （ILD） in patients with sys- temic sclerosis （SSc-ILD）. Methods Twenty initial treatment patients of SSc-ILD were enrolled. They were divided into A group （early metaphase process, n = 12） , and B group （advanced stage process, n =8） based on high-resolution com- puted tomography （HRCT） of chest. The following parameters of two groups were noted at baseline and 24 weeks after treatment with prednisone and Cyclophosphamide （CTX） ： clinical features, pulmonary function tests, HRCT, quality of life. Results Pulmonary infection happened in 10 patients and the incidence rate was 50%. Hemoglobin, erythrocyte sed- imentation rate （ESR） in A group and platelet, ESR, C-reactive protein in B group were significantly improved. HRCT showed that 7 （58.3%） patients improved, and 2 had deteriorated disease in A group and 2 （25%） patients improved, and 6 had deteriorated disease in B group. HRCT score of A group was decreased, but did not show significant change in B group. Pulmonary function in A group was improved compared with B group （ all P 〈 O. 05 ）. Activity scores, impact scores and total scores of SGRQ were decreased, especially activity scores in B group. SF-36 showed improvement in role-physical （RP）, bodily pain （BP） , role-emotional （RE） , mental health of A group and in physical functioning, RP, BP, RE of B group. Conclusions After treatment with prednisone and CTX, patients of SSe-ILD is inclined to pulmonary infection, and their systemic inflammation, quality of life and exercise capacity can be improved. Pulmonary affection and pulmonary function in most of early metaphase patients can be improved, but has no amendment in advanced stage patients.
出处
《山东医药》
CAS
2012年第21期23-26,共4页
Shandong Medical Journal
基金
广西壮族自治区卫生厅自筹经费科研课题(Z2009086)
关键词
硬皮病
系统性
肺疾病
间质性
肺功能
生活质量
scleroderma, systemic
lung disease, interstitial
pulmonary function
quality of life
