Different doses of glucocorticoids combined with N-acetylcysteine in treatment of idiopathic pulmonary fibrosis

沈叶; 崔社怀

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Different doses of glucocorticoids combined with N-acetylcysteine in treatment of idiopathic pulmonary fibrosis

更新时间：2026-01-09

- Different doses of glucocorticoids combined with N-acetylcysteine in treatment of idiopathic pulmonary fibrosis
- Journal of Army Medical University Vol. 34, Issue 6, Pages: 551-554(2012)
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  CLC： R563.13;R977.11;R977.4
- Published：2012
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沈叶,崔社怀.不同剂量糖皮质激素联合N-乙酰半胱氨酸治疗特发性肺纤维化的研究[J].陆军军医大学学报(原第三军医大学学报),2012,34(06):551-554.

　Shen Ye,Cui Shehuai.Different doses of glucocorticoids combined with N-acetylcysteine in treatment of idiopathic pulmonary fibrosis[J].J Amry Med Univ (J Third Mil Med Univ),2012,34(06):551-554.
沈叶,崔社怀.不同剂量糖皮质激素联合N-乙酰半胱氨酸治疗特发性肺纤维化的研究[J].陆军军医大学学报(原第三军医大学学报),2012,34(06):551-554. DOI：

　Shen Ye,Cui Shehuai.Different doses of glucocorticoids combined with N-acetylcysteine in treatment of idiopathic pulmonary fibrosis[J].J Amry Med Univ (J Third Mil Med Univ),2012,34(06):551-554. DOI：

摘要

目的为探讨特发性肺纤维化(idiopathic pulmonary fibrosis，IPF)的治疗新方案，比较静脉推注较大剂量糖皮质激素(80~120 mg/d)联合N-乙酰半胱氨酸与较小剂量糖皮质激素(80 mg/d)联合N-乙酰半胱氨酸治疗IPF的临床疗效。方法根据标准纳入35例受试者，分为治疗组与对照组。观察用药3个月后2组p(O

)、p(CO

)、FVC%pred、FEV1%pred、VC%pred、TLC%pred、DLCO/VA%pred、症状体征评分、HRCT上磨玻璃影、网格影、蜂窝影、小叶间隔增厚的变化情况及不良反应。结果对比各组用药前后的变化，用药3个月后2组肺功能(FVC%pred、FEV1%pred、VC%pred、TLC%pred、DLCO/VA%pred)及p(O

)较用药前升高，p(CO

)较用药前降低，症状体征较用药前缓解，差异均具有统计学意义(P0.05)；而HRCT用药前后变化无显著性差异(P0.05)。对比2组用药后的变化，治疗组用药后FVC%pred、VC%pred、DLCO/VA%pred改善优于对照组，差异具有统计学意义(P0.05)。结论与较小剂量糖皮质激素联合N-乙酰半胱氨酸的治疗方案比较，静脉推注较大剂量糖皮质激素联合N-乙酰半胱氨酸短期治疗特发性肺纤维化更能改善FVC%pred、VC%pred及DLCO/VA%pred，缓解总体症状，且在短期内未表现出明显副作用。

Abstract

Objective To explore a new approach for the treatment of idiopathic pulmonary fibrosis (IPF)

and to compare the clinical effect of intravenous injection of large doses of glucocorticoids (80-120 mg/d) combined with N-acetylcysteine with that of small doses of glucocorticoids (80 mg/d) combined with N-acetylcysteine. Methods According to the inclusion cr

iteria

35 subjects were enrolled and divided into a treatment group (large doses of glucocorticoids) and a control group (small doses of glucocorticoids). The p(O

)

p(CO

)

FVC%pred

FEV1%pred

VC%pred

TLC%pred

DLCO/VA%pred

symptom scores

HRCT changes and adverse reactions of the two groups were observed after three-month treatment. Results After the treatment for three months

p(O

) and pulmonary function (FVC%pred

FEV1%pred

VC%pred

TLC%pred

and DLCO/VA%pred) of both groups increased

p(CO

) decreased

and symptom scores increased as compared with those before treatment. The differences were statistically significant (P0.05). However

HRCT showed no significant difference before and after the treatment (P0.05). As compared with those of the control group

FVC%pred

VC%pred and DLCO/VA%pred of the treatment group improved significantly (P0.05). Conclusion Compared with the small doses of glucocorticoid combined with N-acetylcysteine

intravenous injection of large doses glucocorticoid combined with N-acetylcysteine in treatment of idiopathic pulmonary fibrosis can better improve FVC%pred

VC%pred and DLCO/VA%pred

and relieve general symptoms with no obvious side effects in a short term.

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