目的 探究環(huán)孢素聯(lián)合潑尼松治療特發(fā)性肺間質(zhì)纖維化的臨床療效。方法 選取2017年1月—2018年1月喀什地區(qū)第二人民醫(yī)院醫(yī)治的特發(fā)性肺間質(zhì)纖維化患者62例作為研究對(duì)象，將患者按照隨機(jī)數(shù)字表法均分為對(duì)照組（n=31）和觀察組（n=31）。對(duì)照組的患者口服醋酸潑尼松龍片，劑量為15 mg/d，連續(xù)治療2個(gè)月，而后減量至5~10 mg/d，連續(xù)治療3個(gè)月。觀察組患者在對(duì)照組治療基礎(chǔ)上靜脈滴注環(huán)孢素注射液，2.5 mg應(yīng)用5%葡萄糖液稀釋后緩慢靜滴，1次/d，持續(xù)2周；隨后口服維持量5 g/d，持續(xù)治療3個(gè)月。兩組療程均為5個(gè)月。觀察兩組患者的臨床療效，比較兩組治療前后的肺功能指標(biāo)、免疫功能指標(biāo)、炎性因子、環(huán)瓜氨酸多肽（CCP）和C反應(yīng)蛋白（CRP）水平。結(jié)果 治療后，觀察組和對(duì)照組治療有效率為96.77%和80.65%，兩組對(duì)比的差異存在統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者用力肺活量（FVC）、第1秒用力呼氣容積（FEV₁）和FEV₁/FVC水平均顯著升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；觀察組FVC、FEV₁、FEV₁/FVC水平均顯著高于對(duì)照組（P<0.05）。治療后，兩組患者CD4⁺、CD3⁺水平均顯著升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；觀察組CD4⁺、CD3⁺水平顯著高于對(duì)照組（P<0.05）。治療后，兩組患者白細(xì)胞介素-1β（IL-1β）、腫瘤壞死因子-α（TNF-α）、CCP和CRP水平均顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；觀察組IL-1β、TNF-α、CCP和CRP水平顯著低于對(duì)照組（P<0.05）。結(jié)論 環(huán)孢素聯(lián)合潑尼松對(duì)特發(fā)性肺間質(zhì)纖維化具有較好的治療效果，能夠改善患者的免疫功能和炎性指標(biāo)，降低患者CCP和CRP水平有關(guān)，值得進(jìn)行臨床推廣使用。

Objective To investigate the clinical efficacy of ciclosporin combined with prednisone in treatment of idiopathic pulmonary fibrosis. Methods A total of 62 patients with idiopathic pulmonary fibrosis treated in the Kashi Second People's Hospital from January 2017 to January 2018 were selected as the research objects, and the patients were divided into control group (n=31 cases) and observation group (n=31 cases) according to the random number table method. Patients in the control group were po administered with Prednisolone Acetate Tablets at a dose of 15 mg/d for two consecutive months, and then reduced to 5-10 mg/d for three consecutive months. Patients in the observation group were iv administered with Ciclosporin Injection on the basis of control group, 2.5 mg was diluted with 5% glucose solution, once daily, lasting for two weeks. Then the oral maintenance dose was 5 g/d, and the treatment lasted for three months. Patients in two groups were treated for three months. The clinical efficacy in two groups was observed, and the levels of lung function, immune function, inflammatory factors, cyclic citrinine polypeptide (CCP) and Creactive protein (CRP) between two groups before and after treatment were compared. Results After treatment, the effective rate in the observation group and control group was 96.77% and 80.65%, with statistically significant difference between two groups (P<0.05). After treatment, the levels of FVC, FEV₁ and FEV₁/FVC in two groups were significantly increased, and the difference before and after treatment in the same group was statistically significant (P<0.05). The levels of FVC, FEV₁ and FEV₁/FVC in the observation group were significantly higher than those in the control group (P<0.05). After treatment, the levels of CD4⁺ and CD3⁺ in two groups were significantly increased, and the difference before and after treatment in the same group was statistically significant (P<0.05). The levels of CD4⁺ and CD3⁺ in the observation group were significantly higher than those in the control group (P<0.05). After treatment, the levels of IL-1β, TNF-α, CCP, and CRP in two groups were significantly decreased, and the difference before and after treatment in the same group was statistically significant (P<0.05). The levels of IL-1β, TNF-α, CCP, and CRP in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Ciclosporin combined with prednisone has a good therapeutic effect on idiopathic pulmonary fibrosis, can improve the immune function and inflammatory indicators of patients, and reduce the CCP and CRP levels in patients, which is worthy of clinical promotion.

R974

喀什地區(qū)科學(xué)研究與技術(shù)開(kāi)發(fā)計(jì)劃項(xiàng)目（KS2018016）