摘要
目的观察吡非尼酮对肺间质纤维化患者病情及预后的影响。方法选取驻马店市中心医院2022年1月至2024年1月收治的100例肺间质纤维化患者开展前瞻性随机对照试验,应用双色球法将入组患者分别列为常规组和联合组,每组50例。常规组实施常规治疗,联合组采用吡非尼酮联合常规治疗,治疗结束后随访一年。比较两组炎症指标、肺纤维化指标、肺功能恢复情况以及转化生长因子-β/细胞内信号转导分子(TGF-β/Smad)信号通路相关蛋白。结果治疗后,联合组的白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、单核细胞趋化因子蛋白-1(MCP-1)、趋化因子配体18(CCL18)均低于常规组(P<0.05);联合组的表面活性蛋白A(SP-A)、表面活性蛋白D(SP-D)、基质金属蛋白酶9(MMP9)、涎液化糖链抗原(KL-6)均低于常规组(P<0.05)。截至随访结束时,联合组的一氧化碳弥散量(DLCO)、肺总量(TLC)、第一秒用力呼气容积百分比(FEV1)、用力肺活量(FVC)均高于常规组(P<0.05)。联合组的TGF-β1、Smad2、Smad3蛋白表达均低于常规组(P<0.05)。结论吡非尼酮可通过抑制TGF-β/Smad信号通路活性而减轻肺间质纤维化患者肺部炎症反应并延缓纤维化进程,对促进患者肺功能恢复有积极影响。
Objective Observation of the effect of pirfenidone on the condition and prognosis of patients with pulmonary interstitial fibrosis.Methods A prospective randomized controlled trial was conducted on 100 pulmonary interstitial fibrosis patients admitted to Zhumadian Central Hospital from January 2022 to January 2024,were divided into a conventional group and a combination group using the double color ball method,50 patients in each group.The conventional group received conventional treatment,while the combination group received a combination of pirfenidone and conventional treatment.After treatment,the two groups were followed up for one year.Compare inflammation indicators,pulmonary fibrosis indicators,lung function recovery,and proteins related to the TGF-β/Smad signaling pathway.Results After treatment,the levels of interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),monocyte chemoattractant protein-1(MCP-1),and chemokine ligand 18(CCL18)in the combination group were lower than those in the conventional group(P<0.05);the surface active protein A(SP-A),surface active protein D(SP-D),matrix metalloproteinase 9(MMP9),and salivary liquefied glycan antigen(KL-6)in the combination group were all lower than those in the conventional group(P<0.05).As of the end of follow-up,the combination group had higher diffusion capacity of carbon monoxide(DLCO),total lung volume(TLC),percentage of forced expiratory volume in one second(FEV1),and forced vital capacity(FVC)than the conventional group(P<0.05).The protein expressions of TGF-β1,Smad2 and Smad3 in the combination group were all lower than those in the conventional group(P<0.05).Conclusion Pirfenidone can alleviate pulmonary inflammation and delay fibrosis in pulmonary interstitial fibrosis patients by inhibiting the activity of the TGF-β/Smad signaling pathway,and has a positive effect on promoting the recovery of lung function in patients.
作者
杨珂
张雪珂
YANG Ke;ZHANG Xueke(Zhumadian Central Hospital,Zhumadian Henan 463000,China)
出处
《药品评价》
2025年第5期617-620,共4页
Drug Evaluation
