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霉酚酸钠治疗硬皮病相关间质性肺疾病的疗效。

Effect of mycophenolate sodium in scleroderma-related interstitial lung disease.

机构信息

Internal Medicine Service, Hospital Universitario Vall d'Hebron, Passeig Vall d'Hebron 119-129, Barcelona, Spain.

出版信息

Clin Rheumatol. 2011 Nov;30(11):1393-8. doi: 10.1007/s10067-011-1823-1. Epub 2011 Sep 1.

Abstract

This study aims to determine the effectiveness of mycophenolate sodium (MS) in patients with scleroderma (SSc)-related interstitial lung disease (ILD). In a prospective observational study, we evaluated 14 consecutive SSc-ILD patients who were treated with MS for 12 months. The effect of MS on lung function was examined by using longitudinal data analytic methods. Wilcoxon rank-sum tests were used to examine the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and diffusing capacity of the lung for carbon monoxide (DLCO) by pulmonary function testing. As a group, the median values for FVC, FEV1 and DLCO did not change significantly after 12 months of MS therapy and fulfilled the definition of stable disease by the American Thoracic Society. Individually, after 12 months of treatment, 6 out of 14 patients showed a pulmonary improvement defined as an increase of more than 10% in FVC, and 5 out of 14 patients remained stable. By contrast, the median FVC had declined a non-significant 7.2% from the previous 12 months before MS initiation. No significant drug adverse effects were registered. These prospective data suggest that MS is a safe and well-tolerated therapy for SSc-ILD patients, and it is capable of preventing functional pulmonary deterioration.

摘要

本研究旨在确定霉酚酸酯钠(MS)在硬皮病(SSc)相关间质性肺病(ILD)患者中的疗效。在一项前瞻性观察研究中,我们评估了 14 例连续的 SSc-ILD 患者,他们接受 MS 治疗 12 个月。通过使用纵向数据分析方法来评估 MS 对肺功能的影响。Wilcoxon 秩和检验用于通过肺功能测试检查用力肺活量(FVC)、1 秒用力呼气量(FEV1)和一氧化碳弥散量(DLCO)。作为一个整体,在 MS 治疗 12 个月后,FVC、FEV1 和 DLCO 的中位数值没有显著变化,并且符合美国胸科学会定义的稳定疾病。在个体方面,经过 12 个月的治疗后,14 名患者中有 6 名表现出肺功能改善,定义为 FVC 增加超过 10%,而 14 名患者中有 5 名保持稳定。相比之下,在开始使用 MS 之前的前 12 个月,中位 FVC 已经下降了非显著的 7.2%。没有报告明显的药物不良反应。这些前瞻性数据表明,MS 是 SSc-ILD 患者安全且耐受良好的治疗方法,能够预防肺功能恶化。

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