环磷酰胺联合谷胱甘肽治疗原发性干燥综合征肺间质病变安全性及疗效评价(1)
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【摘要】 目的 评价环磷酰胺联合谷胱甘肽治疗原发性干燥综合征肺间质病变安全性及疗效。方法 随机将86例原发性干燥综合症肺间质病变(pSS-ILD)患者分为治疗组和对照组，所有患者在给羟氯喹治疗原发病的同时，均应用糖皮质激素和环磷酰胺冲击治疗，治疗组同时于应用环磷酰胺前后加用还原性谷胱甘肽2.4 g/d，每次共7 d。观察两组患者治疗后6个月肺HRCT、肺功能、血常规、血沉、肝功能及免疫球蛋白的变化情况及临床症状改善情况。结果 两组患者在治疗6个月时其肺HRCT、肺功能、血沉、CRP、免疫球蛋白较前有明显好转(P<0.01)，而且治疗组的各项临床指标的改善明显优于对照组(P<0.05)，治疗组不良事件发生率明显低于对照组(P<0.001)，且无失访患者。结论 1.环磷酰胺治疗pSS-ILD有明显的疗效；2.环磷酰胺联合谷胱甘肽治疗pSS-ILD疗效明显优于单用环磷酰胺组，且有更高的安全性。
【关键词】 环磷酰胺；谷胱甘肽； 干燥综合征； 肺间质病变
Effects and Safety of Cyclophosphamide Combined With Glutathione in Treatment of Interstitial Lung Disease Associated With Primary Sjogren Syndrome
MA Xin-mei,ZHANG Hua, HOU Na-li, et al.Department of Rheumatology＆ Immunology,Zaozhuang municipal hospital Shandong 277102,China
【Abstract】 Objective To evaluate the efficacy and safety of Cyclophosphamide(CTX) combined with glutathione(GSH) in treatment of interstitial lung disease associated with primary Sjogren syndrome(ILD-pSS). Methods 86 cases of ILD-pSS were randomly divided into treatment and control groups. All patients were treated with hydroxychloroquine,glucocorticoids and cyclophosphamide pulse; While patients in treatment group were treated with reduced glutathione 2.4 g/d before and after the application of cyclophosphamide pulse for 7 days. Lung HRCT, pulmonary function, blood erythrocyte sedimentation rate, liver function, immunoglobulin and the clinical symptoms were observed before and after treatment for 6 months. Results Compared with untreated patients, pulmonary HRCT, pulmonary function, ESR, CRP, immunoglobulin were markedly improved after treatment for 6 months in two groups(P<0.01).Clinical parameters were improved better in treatment group than in the control group (P<0.05).Compared with the control group,the rates of adverse events were significantly decreased in treatment group(P<0.001).Conclusion 1. cyclophosphamide pulse was effective strategy for pSS-ILD.2. Compared with cyclophosphamide pulse treament alone, the effect and security were significantly improved by the treatment combined cyclophosphamide pulse with glutathione for patients with pSS-ILD ......
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