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吡非尼酮对间质性肺炎急性加重期患者的影响。

The effects of pirfenidone in patients with an acute exacerbation of interstitial pneumonia.

作者信息

Matsumura Takuma, Tsushima Kenji, Abe Mitsuhiro, Suzuki Kenichi, Yamagishi Kazutaka, Matsumura Akane, Ichimura Yasunori, Ikari Jun, Terada Jiro, Tatsumi Koichiro

机构信息

Department of Respirology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba 260-8670, Japan.

出版信息

Clin Respir J. 2018 Apr;12(4):1550-1558. doi: 10.1111/crj.12704. Epub 2017 Sep 27.

Abstract

INTRODUCTION

The prognosis of patients with an acute exacerbation of interstitial pneumonia (AE-IP) is poor. Pirfenidone (PFD) reduces the disease progression in idiopathic pulmonary fibrosis.

OBJECTIVES

The purpose of this study was evaluating whether the administration of PFD improved the outcomes of AE-IP.

METHODS

We conducted a retrospective study of 31 patients with AE-IP who did not recover between 7 and 14 days after an initial treatment. Fourteen patients received PFD within 2 weeks (PFD group) of the AE, while 17 patients were treated without PFD (non-PFD group). The patients' clinical data and computed tomography (CT) scores were analyzed.

RESULTS

The survival rate in the PFD group was not significantly different from non-PFD group at 30 (78.6% vs 64.7%, P = .46) and 90 days (64.3% vs 52.9%, P = .72). The white blood cell counts in the PFD group were significantly lower on PFD day 14 than on PFD days 1 and 7. The C-reactive protein levels in the PFD group were also significantly lower on PFD day 7 than on PFD day 1. There were no significant differences regarding the changes of the CT scores.

CONCLUSIONS

PFD may reduce the inflammation in AE-IP patients undergoing corticosteroid treatment.

摘要

引言

间质性肺炎急性加重期(AE - IP)患者的预后较差。吡非尼酮(PFD)可减缓特发性肺纤维化的疾病进展。

目的

本研究旨在评估PFD的使用是否能改善AE - IP的预后。

方法

我们对31例初始治疗后7至14天未康复的AE - IP患者进行了一项回顾性研究。14例患者在AE发生后2周内接受了PFD治疗(PFD组),而17例患者未接受PFD治疗(非PFD组)。分析了患者的临床数据和计算机断层扫描(CT)评分。

结果

PFD组在30天(78.6%对64.7%,P = 0.46)和90天(64.3%对52.9%,P = 0.72)时的生存率与非PFD组无显著差异。PFD组在第14天时的白细胞计数显著低于第1天和第7天。PFD组在第7天时的C反应蛋白水平也显著低于第1天。CT评分的变化无显著差异。

结论

PFD可能会减轻接受皮质类固醇治疗的AE - IP患者的炎症。

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