【摘要】 目的评估吡非尼酮与N-乙酰半胱氨酸(NAC)联合治疗肺纤维化的有效性及安全性,为临床用药提供依据。方法收集1例由肺纤维化合并肺气肿综合征(CPFE)发展为特发性肺纤维化(IPF)患者的资料,用"pirfenidone"及"N-acetylcysteine"为关键词在PubMed数据库中检索,筛选符合标准的文献,提取数据结合有关文献进行回顾性分析。结果患者男,70岁,临床诊断为CPFE进展为IPF,2018年2月开始使用吡非尼酮联合乙酰半胱氨酸抗纤维化治疗,肺功能指标、CT检查结果均有改善,无明显不良反应,治疗效果良好。共检索到6篇相关文献,其中4篇的研究结果显示吡非尼酮联合NAC治疗肺纤维化效果优于吡非尼酮或NAC单药治疗。另外2篇的研究结果显示吡非尼酮联合NAC治疗患者疾病进展率高于吡非尼酮单药治疗组。结论吡非尼酮联合NAC对改善IPF患者肺功能有一定作用,联合治疗可能优于单药治疗。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of pirfenidone combined with N-acetylcysteine(NAC) in the treatment of pulmonary fibrosis, aiming to provide basis for clinical medication. Methods Clinical data of 1 patient with combined pulmonary fibrosis and emphysema(CPFE) progressing into idiopathic pulmonary fibrosis(IPF) were reviewed. Relevant literature was searched and screened from PubMed using the keywords of “pirfenidone”and “N-acetylcysteine”. The extracted data and relevant literature were collected for retrospective analysis. Results The male patient, aged 70 years old, was clinically diagnosed with CPFE which progressed into IPF. In February, 2018, he was treated with pirfenidone combined with NAC. Pulmonary function indexes and CT scan data were improved. No significant adverse events were observed. High clinical efficacy was achieved. Six studies were retrieved in this study. The findings in 4 studies showed that the efficacy of pirfenidone combined with NAC was better than that of monotherapy in the treatment of pulmonary fibrosis. The results in the other 2 studies demonstrated that the disease progression rate of patients treated with pirfenidone combined with NAC was higher compared with that of pirfenidone alone. Conclusions Pirfenidone combined with NAC yield certain effect upon improving the lung function of IPF patients. Clinical efficacy of combined therapy is probably higher compared with that of monotherapy.更多还原