[糖皮质激素治疗特发性非特异性间质性肺炎的疗效研究]

[A study on the efficacy of glucocorticoid therapy for idiopathic nonspecific interstitial pneumonia].

作者信息

Wu Xi-Ya, Yi Xiang-Hua, Li Hui-Ping, Luo Ben-Fang, Li Xia, Wang Yan-Li, Zeng Yu, Rui Wei-We, Zhu Xu-You, Li Xiao-Jing

机构信息

Department of Pathology, Tongji Hospital of Tongji University, Shanghai 200065, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2010 Aug;33(8):593-6.

PMID:20979847

Abstract

OBJECTIVE

To investigate the efficacy of glucocorticoid therapy in idiopathic nonspecific interstitial pneumonia (INSIP).

METHODS

Twenty-nine cases of INSIP confirmed by clinical- radiological-pathological (CRP) diagnosis were collected and classified into 2 groups according to the degree of fibrosis: INSIP-1 (including 9 cases of cellular type) and INSIP-2 (20 cases of mixed and fibrotic type). Thirty cases of usual interstitial pneumonia (UIP) confirmed by CRP diagnosis served as the control. Clinical and pathological features, therapeutic effects of glucocorticoids and the follow-up results were retrospectively analyzed and the survival curves were evaluated by Kaplan-Meier method.

RESULTS

The mean age at onset of INSIP-1 group [(48 ± 5) years] was significantly younger than INSIP-2 group [(52 ± 11) years] and the UIP group [(57 ± 14) years]. The course of disease in INSIP-1 group [(60 ± 28) months] was longer than that in INSIP-2 group [(48 ± 33) months] and that in the UIP group [(44 ± 23) months], but the differences were not statistically significant (F = 1.22, all P > 0.05). The efficacy rate of glucocorticoid treatment in INSIP-1 group (9/9) was higher than that in INSIP-2 group (11/20) and that in the UIP group (2/30), the differences being statistically significant (all P < 0.05). The follow-up period for INSIP-1 group [(56 ± 27) months] was significantly longer than for INSIP-2 group [(23 ± 18) months] and for the UIP group [(25 ± 17) months], and the rate of significant improvement (6/9) was higher than that of the INSIP-2 group (9/20) and the UIP group (0/30), the differences being statistically significant (F = 9.224, all P < 0.05). The mortality of INSIP-1 group (0/9) was lower than that in INSIP-2 group (4/20) and the UIP group (16/30), the difference being statistically significant (exact probability value 0.000 - 0.005, P < 0.05).

CONCLUSIONS

The degree of fibrosis of INSIP is closely correlated with the effect of glucocorticoid therapy and prognosis. The cellular type has a favorable reaction to glucocorticoid therapy and a better prognosis as compared to the fibrotic type.

摘要

目的

探讨糖皮质激素治疗特发性非特异性间质性肺炎（INSIP）的疗效。

方法

收集29例经临床-放射-病理（CRP）诊断确诊的INSIP患者，并根据纤维化程度分为2组：INSIP-1组（包括9例细胞型）和INSIP-2组（20例混合型和纤维化型）。选取30例经CRP诊断确诊的普通间质性肺炎（UIP）患者作为对照。回顾性分析临床和病理特征、糖皮质激素治疗效果及随访结果，采用Kaplan-Meier法评估生存曲线。

结果

INSIP-1组发病时的平均年龄[（48±5）岁]显著低于INSIP-2组[（52±11）岁]和UIP组[（57±14）岁]。INSIP-1组的病程[（60±28）个月]长于INSIP-2组[（48±33）个月]和UIP组[（44±23）个月]，但差异无统计学意义（F = 1.22，所有P>0.05）。INSIP-1组糖皮质激素治疗有效率（9/9）高于INSIP-2组（11/20）和UIP组（2/30），差异有统计学意义（所有P<0.05）。INSIP-1组的随访时间[（56±27）个月]显著长于INSIP-2组[（23±18）个月]和UIP组[（25±17）个月]，且显著改善率（6/9）高于INSIP-2组（9/20）和UIP组（0/30），差异有统计学意义（F = 9.224，所有P<0.05）。INSIP-1组的死亡率（0/9）低于INSIP-2组（4/20）和UIP组（16/30），差异有统计学意义（确切概率值0.000 - 0.005，P<0.05）。