Matsumura Takuma, Tsushima Kenji, Abe Mitsuhiro, Suzuki Kenichi, Yamagishi Kazutaka, Matsumura Akane, Ichimura Yasunori, Ikari Jun, Terada Jiro, Tatsumi Koichiro
Department of Respirology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba 260-8670, Japan.
Clin Respir J. 2018 Apr;12(4):1550-1558. doi: 10.1111/crj.12704. Epub 2017 Sep 27.
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.
The purpose of this study was evaluating whether the administration of PFD improved the outcomes of AE-IP.
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.
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.
PFD may reduce the inflammation in AE-IP patients undergoing corticosteroid treatment.
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。
本研究旨在评估PFD的使用是否能改善AE - IP的预后。
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。
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。
PFD可能会减轻接受皮质类固醇治疗的AE - IP患者的炎症。
