本文選題：結(jié)締組織病 + 肺間質(zhì)病變�。� 參考：《山西醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的:1、觀察來(lái)氟米特(LEF)聯(lián)合小劑量環(huán)磷酰胺(CTX)對(duì)結(jié)締組織病合并肺間質(zhì)病變(CTD-ILD)的療效;2、比較LEF聯(lián)合小劑量CTX組及單用LEF組不同方案對(duì)CTD-ILD的療效。方法:選取我科確診的CTD-ILD患者32例,隨機(jī)分為2組:單用藥組(LEF)和聯(lián)合用藥組(LEF+小劑量CTX組)。收集臨床資料:記錄患者治療前及治療6個(gè)月后的臨床表現(xiàn)(呼吸道癥狀、VelcroUp音)、ESR、血清表面活性蛋白(SP-A、SP-D)、肺功能(用力肺活量FVC和一氧化碳彌散DLCO)、肺高分辨率CT(HRCT)及不良反應(yīng),整理資料,統(tǒng)計(jì)分析。血清表面活性蛋白SP-A和SP-D的檢測(cè):清晨空腹采血,采集18例健康對(duì)照人群、32例CTD-ILD患者治療前和治療6個(gè)月后的外周靜脈血2.0-3.0m L,離心后吸取上層血清,-80℃冰箱保存,避免血清反復(fù)凍融,標(biāo)本收集齊后采用ELISA法集中測(cè)試。結(jié)果:1、臨床表現(xiàn):32例患者治療前后以及不同用藥組呼吸道癥狀及VelcroUp音的變化無(wú)差異,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);2、ESR:32例患者治療后ESR較治療前明顯下降(P0.001),但不同用藥組之間ESR水平無(wú)差異(P0.05);3、SP-A和SP-D:治療后較治療前SP-A水平明顯下降(P0.05),且聯(lián)合組較單用藥組SP-A水平下降更顯著(P0.001);治療后與治療前SP-D水平無(wú)差異(P0.05),但聯(lián)合用藥組SP-D水平較單用藥組明顯降低(P0.05);4、肺功能:聯(lián)合用藥組FVC水平較單用藥組有明顯改善(P0.05),DLCO改善無(wú)顯著差異(P0.05);5、聯(lián)合用藥組肺HRCT較治療前有明顯改善;6、治療6個(gè)月,在不良事件的發(fā)生方面聯(lián)合用藥組與單用藥組相比無(wú)明顯增多。結(jié)論:1、LEF聯(lián)合小劑量CTX治療CTD-ILD,能改善其ESR、SP-A及FVC;2、聯(lián)合用藥組能有效降低CTD-ILD特異的血清學(xué)標(biāo)志物SP-A和SP-D;3、聯(lián)合治療組較單用藥組療效顯著,且不良事件發(fā)生較單用藥組并無(wú)增多。
[Abstract]:Objective: 1, to observe the effect of leflunomide (LEF) combined with small dose cyclophosphamide (CTX) on connective tissue disease with interstitial lung disease (CTD-ILD). 2, compare the effect of LEF combined with small dose CTX group and single LEF group on CTD-ILD. Methods: 32 patients with CTD-ILD were selected and divided into 2 groups randomly: single drug group (LEF) and combined use of drugs. Group (LEF+ small dose CTX group). The clinical data were collected: the clinical manifestations (respiratory symptoms, VelcroUp sounds), ESR, serum surface active protein (SP-A, SP-D), pulmonary function (vital capacity FVC and carbon monoxide dispersion DLCO), pulmonary high resolution CT (HRCT) and adverse reactions, the data, statistical analysis of the serum, and the statistical analysis. The detection of surface active protein SP-A and SP-D: 18 cases of healthy controls were collected in the morning on empty stomach. 32 cases of CTD-ILD patients were treated with 2.0-3.0m L before and after 6 months of treatment. After centrifugation, the upper serum was absorbed and the refrigerator was stored at -80 C to avoid repeated freeze-thaw. The specimens were collected and collected by ELISA method. Results: 1, clinical manifestations: There was no difference in respiratory symptoms and VelcroUp sounds in 32 patients before and after treatment, and there was no significant difference (P0.05). 2, ESR in ESR:32 patients decreased significantly after treatment (P0.001), but there was no difference between ESR levels (P0.05) between different medication groups (P0.05); SP-A and SP-D: were significantly lower than those before treatment (P0.05) (P0.05). And the SP-A level of the combined group was significantly lower than that in the single drug group (P0.001), and there was no difference in the level of SP-D before treatment (P0.05), but the SP-D level of the combined drug group was significantly lower than that in the single drug group (P0.05); 4, the lung function: the FVC level of the combined drug group was significantly improved (P0.05) and the DLCO improvement was not significant (P0.05); 5, the combination group was not significantly different (P0.05). The lung HRCT was significantly better than before the treatment; 6, for 6 months, the combination group had no significant increase in the incidence of adverse events. Conclusion: 1, LEF combined with small dose CTX for CTD-ILD, can improve its ESR, SP-A and FVC; 2, the combination group can effectively reduce CTD-ILD specific serological markers SP-A and SP-D; 3, combined treatment group. Compared with the single medication group, the curative effect was significant, and the incidence of adverse events was not increased compared with the single medication group.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R593.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 趙晨宇;尹雯;李志勇;謝華;朱丹;;肺纖維化的臨床藥物治療新進(jìn)展[J];中國(guó)藥房;2014年10期

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本文編號(hào)：2046098