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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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