摘要
目的:探讨低分子肝素联合乙酰半胱氨酸(Acetylcysteine,AC)治疗特发性间质性肺炎(idipathic interstitial pneumonia,IIP)患者的疗效分析及其对涎液化糖链抗原-6(Krebs von den Lungen-6,KL-6)、过氧化物酶体增殖物激活受体γ(peroxisome proliferator-activated receptor gamma,PPARγ)水平及肺纤维化相关因子表达的影响。方法:选取我科2018年7月至2020年9月期间89例IIP患者作为研究对象,按照随机抽样法分成两组,对照组44例给予常规治疗,观察组45例给予低分子肝素联合AC治疗,12周后观察两组患者的临床疗效、肺功能、血清学指标、肺纤维化相关指标、不良反应。结果:观察组治疗后总有效率97.78%(44/45),高于对照组的79.55%(35/44),差异有统计学意义(χ^(2)=5.6996,P<0.05);两组患者治疗后各项肺功能指标均有改善,且观察组患者改善程度优于对照组(P<0.05);两组患者治疗后转化生长因子β1(transforming growth factor-β1,TGF-β1)、KL-6均降低,PPARγ均升高,且观察组患者变化程度大于对照组(P<0.05);两组患者治疗后结缔组织生长因子(Connective tissue growth factor,CTGF)、纤维连接蛋白(fibronectin,FN)水平均降低,且观察组患者降低程度更明显(P<0.05);观察组患者总不良反应发生率2.22%(1/45),低于对照组的18.18%(8/44)(χ^(2)=7.7689,P<0.05)。结论:低分子肝素联合AC治疗IIP患者的疗效确切,能有效改善患者的肺功能,抑制肺纤维化相关因子的表达,安全可靠,值得临床推广使用。
Objective:To investigate the efficacy of low molecular weight heparin combined with AC in the treatment of idiopathic interstitial pneumonia(IIP)and its effect on the levels of Krebs von den Lungen-6(KL-6),peroxisome proliferator-activated receptor gamma(PPAR)and the expression of factors related with pulmonary fibrosis.Methods:A total of 89 patients with IIP in our department from July 2018 to September 2020 were selected as the research objects and divided into the observation group and the control group according to the random sampling method.The 44 patients in the control group were given conventional treatment,while the 45 patients in the observation group were given low molecular weight heparin combined with acetylcysteine(AC)treatment,with the clinical efficacy,pulmonary function,serological indexes,pulmonary fibrosis related indicators,adverse reactions observed 12 weeks later.Results:The total effective rate in the observation group was 97.78%(44/45,higher than that in the control group(79.55%)(35/44,the difference being significant(χ^(2)=5.6996,P<0.05).After treatment,lung function indexes of both groups were improved,but the improvement degree of the observation group was higher than that of the control group(P<0.05).Transforming growth factor-β1(TGF-β1)and KL-6 were decreased and PPAR were increased in both groups after treatment,but the decrease and increase rates in the observation group were higher than those in the control group(P<0.05).The levels of connective tissue growth factor(CTGF)and fibronectin(FN)in both groups were decreased after treatment,but the decrease rate in the observation group was higher than that in the control group(P<0.05).The incidence of total adverse reactions in the observation group was 2.22%(1/45),lower than that in the control group(18.18%)(8/44)(χ^(2)=7.7689,P<0.05).Conclusion:Low molecular weight heparin combined with AC has a definite therapeutic effect on IIP patients,can effectively improve the pulmonary function of patients and inhibit the expression of pulmonary fibrosis related factors,which is safe,reliable and worthy of clinical promotion.
作者
田灵敏
TIAN Lingmin(Zhecheng Hospital of Traditional Chinese Medicine,Shangqiu 476200,China)
出处
《包头医学院学报》
CAS
2021年第9期43-47,共5页
Journal of Baotou Medical College
关键词
低分子肝素
乙酰半胱氨酸
特发性间质性肺炎
肺纤维化相关因子
Low molecular weight heparin
Acetylcysteine
Idiopathic interstitial pneumonia
Factors associated with pulmonary fibrosis
