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吡非尼酮早期治疗对特发性肺纤维化患者肺功能的疗效研究。

Study on the efficacy of early treatment with pirfenidone on the lung function of patients with idiopathic pulmonary fibrosis.

作者信息

Lei Ying, Sheng Jian-Hui, Jin Xu-Ru, Liu Xian-Bing, Zheng Xiao-Yan, Xu Xiao-Hua

机构信息

Department of Pulmonary and Critical Care Medicine, The Quzhou Affiliate Hospital of Wenzhou Medical University, Quzhou 324000, Zhejiang Province, China.

Department of Clinical Laboratory, The Quzhou Affiliate Hospital of Wenzhou Medical University, Quzhou 324000, Zhejiang Province, China.

出版信息

World J Clin Cases. 2024 Aug 6;12(22):4913-4923. doi: 10.12998/wjcc.v12.i22.4913.

Abstract

BACKGROUND

Idiopathic pulmonary fibrosis (IPF) is classified under fibrotic interstitial pneumonia, characterized by a chronic and progressive course. The predominant clinical features of IPF include dyspnea and pulmonary dysfunction.

AIM

To assess the effects of pirfenidone in the early treatment of IPF on lung function in patients.

METHODS

A retrospective analysis was performed on 113 patients with IPF who were treated in our hospital from November 2017 to January 2023. These patients were divided into two groups: control group ( = 53) and observation group ( = 60). In the control group, patients received routine therapy in combination with methylprednisolone tablets, while those in the observation group received routine therapy together with pirfenidone. After applying these distinct treatment approaches to the two groups, we assessed several parameters, including the overall effectiveness of clinical therapy, the occurrence of adverse reactions ( nausea, vomiting, and anorexia), symptom severity scores, pulmonary function index levels, inflammatory marker levels, and the 6-min walk distance before and after treatment in both groups.

RESULTS

The observation group exhibited significantly higher rates than the control group after therapy, with a clear distinction ( < 0.05). After treatment, the observation group experienced significantly fewer adverse reactions than the control group, with a noticeable difference ( < 0.05). When analyzing the symptom severity scores between the two groups of patients after treatment, the observation group had significantly lower scores than the control group, with a distinct difference ( < 0.05). When comparing the pulmonary function index levels between the two groups of patients after therapy, the observation group displayed significantly higher levels than the control group, with a noticeable difference ( < 0.05). Evaluating the inflammatory marker data (C-reactive protein, interleukin-2 [IL-2], and IL-8) between the two groups of patients after therapy, the observation group exhibited significantly lower levels than the control group, with significant disparities ( < 0.05). Comparison of the 6-min walking distance data between the two groups of patients after treatment showed that the observation group achieved significantly greater distances than the control group, with a marked difference ( < 0.05).

CONCLUSION

Prompt initiation of pirfenidone treatment in individuals diagnosed with IPF can enhance pulmonary function, elevate inflammatory factor levels, and increase the distance covered in the 6-min walk test. This intervention is conducive to effectively decreasing the occurrence of adverse reactions in patients.

摘要

背景

特发性肺纤维化(IPF)归类于纤维化间质性肺炎,其特点是病程慢性且呈进行性发展。IPF的主要临床特征包括呼吸困难和肺功能障碍。

目的

评估吡非尼酮早期治疗IPF对患者肺功能的影响。

方法

对2017年11月至2023年1月在我院接受治疗的113例IPF患者进行回顾性分析。这些患者被分为两组:对照组(n = 53)和观察组(n = 60)。对照组患者接受常规治疗联合甲泼尼龙片,而观察组患者接受常规治疗联合吡非尼酮。对两组采用不同的治疗方法后,我们评估了几个参数,包括临床治疗的总体有效性、不良反应(恶心、呕吐和厌食)的发生情况、症状严重程度评分、肺功能指标水平、炎症标志物水平以及两组治疗前后的6分钟步行距离。

结果

治疗后观察组的各项指标发生率均显著高于对照组,差异有统计学意义(P < 0.05)。治疗后,观察组的不良反应明显少于对照组,差异有统计学意义(P < 0.05)。分析两组患者治疗后的症状严重程度评分时,观察组的评分明显低于对照组,差异有统计学意义(P < 0.05)。比较两组患者治疗后的肺功能指标水平时,观察组明显高于对照组,差异有统计学意义(P < 0.05)。评估两组患者治疗后的炎症标志物数据(C反应蛋白、白细胞介素 - 2 [IL - 2]和IL - 8),观察组明显低于对照组,差异有统计学意义(P < 0.05)。比较两组患者治疗后的6分钟步行距离数据,观察组的步行距离明显长于对照组,差异有统计学意义(P < 并0.05)。

结论

对诊断为IPF的患者尽早开始吡非尼酮治疗可改善肺功能、提高炎症因子水平并增加6分钟步行试验中的步行距离。这种干预措施有利于有效减少患者不良反应的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0b9/11238781/e9bc32b5876b/WJCC-12-4913-g001.jpg

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