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Received:May 04, 2022 Published Online:January 20, 2023
Received:May 04, 2022 Published Online:January 20, 2023
中文摘要: 目的探讨艾拉莫德联合甲泼尼龙(美卓乐)、硫酸羟氯喹在原发性干燥综合征合并间质性肺病(ILD)患者治疗中的应用和临床疗效。
方法选取南京医科大学附属淮安第一医院2020年1月至2021年12月符合原发性干燥综合征合并ILD、临床资料完备的门诊及住院患者60例,随机分为治疗组30例和对照组30例。对照组给予美卓乐联合硫酸羟氯喹口服治疗,治疗组在对照组基础上加用艾拉莫德片口服治疗。观察两组治疗前后呼吸困难修正评分量表(mMRC)评分、肺功能指标[用力肺活量(FVC)、单位肺泡容积的一氧化碳弥散量占预计值百分比(DLco/VA)]、免疫球蛋白(Ig)G和动脉氧分压(PaO2)水平,并进行对比。
结果治疗12周后,治疗组mMRC评分[(1.82±0.63)分vs(2.26±0.79)分,P<0.05]低于对照组;治疗组FVC[(2.36±0.41)Lvs(2.13±0.22)L]、DLco/VA[(70.83±5.99)%vs(65.17±6.22)%]均明显优于对照组(P<0.05);治疗组IgG水平[(15.86±4.38)g/Lvs(19.03±4.67)g/L,P<0.05]低于对照组;治疗组PaO2水平[(69.70±9.60)mmHgvs(63.57±10.73)mmHg,P<0.05]高于对照组。治疗组发生消化道症状2例,肝损害1例,对照组消化道症状2例,无其他严重并发症和不良反应发生。
结论艾拉莫德联合美卓乐、硫酸羟氯喹对原发性干燥综合征合并ILD有一定短期临床疗效,能改善患者呼吸困难、肺功能、PaO2,降低IgG水平,优于美卓乐和硫酸羟氯喹两药联合治疗。
Abstract:ObjectiveToinvestigatetheclinicalefficacyofiguratimodcombinedwithmethylprednisolone(medrol)andhydroxychloroquinesulfateinpatientswithprimarySjogrenssyndrome(pSS)complicatedwithinterstitialpneumoniadisease(ILD).
MethodsSixtyoutpatientsandinpatientswithpSSandILDtreatedinHuaianNo.1PeoplesHospitalofNanjingMedicalUniversityfromJanuary2020toDecember2021wererandomlydividedintotreatmentgroupandcontrolgroup(n=30,each).Medroltabletscombinedwithhydroxychloroquinesulfateweregivenorallyincontrolgroup,andiguratimodtabletswereaddedintreatmentgroup.ThemodifiedBritishMedicalResearchCouncildyspneascale(mMRC),pulmonaryfunctionindexes[forcedvitalcapacity(FVC),DLco/VA(thepercentageofdiffusingcapacityforcarbonmonoxide/alveolarvolumetothepredictedvalue)]andthelevelsofimmunoglobulinG(IgG)andarterialpartialpressureofoxygen(PaO2)wereobservedbeforeandaftertreatmentandcomparedbetweentwogroups.
ResultsAfter12weeksoftreatment,mMRCscoreintreatmentgroupwasstatisticallylowerthanthatincontrolgroup[(1.82±0.63)vs(2.26±0.79),P<0.05];FVC[(2.36±0.41)Lvs(2.13±0.22)L,P<0.05]andDLco/VA[(70.83±5.99)%vs(65.17±6.22)%,P<0.05]intreatmentgroupweresignificantlysuperiortothoseincontrolgroup;IgGlevel[(15.86±4.38)g/Lvs(19.03±4.67)g/L]significantlydecreasedintreatmentgroup,andPaO2[(69.70±9.60)mmHgvs(63.57±10.73)mmHg]increasedcomparedwiththoseincontrolgroup(P<0.05).Therewere2casesofdigestivetractsymptomsand1caseofliverdamageintreatmentgroupand2casesofdigestivetractsymptomsincontrolgroup,withoutotherseriouscomplicationsandadversereactionsintwogroups.
ConclusionIguratimodcombinedwithmethylprednisoloneandhydroxychloroquinesulfatehavetheadvantagesofabettershort-termeffectonpSSwithIPD.Itcanimprovepatientsdyspnea,pulmonaryfunctionandPaO2,andreduceIgGlevelwhichissuperiortothecombinationofmethylprednisoloneandhydroxychloroquinesulfate.
keywords: Iguratimod PrimarySjogrenssyndrome Lungdisease,interstitial Methylprednisolone Hydroxychloroquinesulfate
文章编号: 中图分类号:R593.2 文献标志码:B
基金项目:江苏省淮安市卫生健康面上项目(HAWJ201902)
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