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以大剂量强的松(P组)治疗18例特发性肺纤维化(IPF)作为对照,与间断静脉滴注环磷酰胺(CTX)加小剂量强的松(C+P)组治疗的16例IPF患者进行了对比观察。C+P组的好转率为75％,动脉氧分压(PaO_2)由治疗前的6.80±2.13kPa升至8.98±2.20kPa(P<0.01),肺活量(VC)由1.46±0.57升至2.08±0.52升(P<0.01),患者对间断静脉应用CTX耐受良好,病死率6.25％。P组的好转率仅为27.6％,PaO_2和VC与治疗前相比均无显著变化(P>0.05),22.2％的患者出现明显的糖皮质激素副作用,病死率高达27.6％。研究表明,C+P是治疗IPF较好的方法,其疗效显著优于大剂量强的松,多数患者耐受良好。
Eighteen patients with idiopathic pulmonary fibrosis (IPF) were treated with high dose prednisone (P group) as control, and intermittent intravenous cyclophosphamide (CTX) plus low dose prednisone (C + P) 16 cases of IPF patients were compared. The improvement rate of PaO_2 increased from 6.80 ± 2.13kPa before treatment to 8.98 ± 2.20kPa (P <0.01), while the vital capacity (VC) increased from 1.46 ± 0.57 to 2.08 ± 0.52 liters (P <0.01), patients with intermittent intravenous CTX well tolerated, the case fatality rate of 6.25%. The improvement rate of P group was only 27.6%, PaO_2 and VC had no significant changes compared with before treatment (P> 0.05), 22.2% of patients showed obvious glucocorticoid side effects, the mortality rate was as high as 27.6%. Studies have shown that C + P is a good method of treatment of IPF, the effect was significantly better than high-dose prednisone, most patients were well tolerated.