Clinical efficacy of tetrandrine in artificial stone-associated silicosis: A retrospective cohort study.
Clinical efficacy of tetrandrine in artificial stone-associated silicosis: A retrospective cohort study.
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DOI：
10.3389/fmed.2023.1107967
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发表时间：
2023
影响因子：
3.9
通讯作者：
中科院分区：
文献类型：
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硅肺的爆发发生在人造石（AS）行业的工人中，目前还没有有效的抗纤维化治疗硅肺。回顾性队列研究。我们回顾性分析了在上海市肺科医院（中国）治疗的89例人工结石相关矽肺患者的临床资料。同意使用汉防已甲素的患者进入观察组，不同意的患者进入对照组。比较两组患者治疗前后胸部HRCT、肺功能及临床症状的变化。治疗3-12个月后，观察组56.5%~ 65.4%的患者HRCT影像学改善，而对照组无改善（p < 0.05）。治疗3-12个月后，观察组0%-17.4%的患者发生疾病进展，对照组44.4%-92.0%的患者发生疾病进展（p < 0.05）。治疗3个月后，观察组用力肺活量（FVC）、第1秒用力呼气量（FEV 1）、肺一氧化碳弥散量（DLco）增加136.7 ± 189.2 mL（p < 0.05）、124.2 ± 169.9 mL（p < 0.05）和1.4 ± 2.3 mL/min/mmHg（p > 0.05），而对照组的这些降低（145.8 ± 356.5; 107.5 ± 272.1; 1.9 ± 3.8）。治疗6个月后，观察组FVC、FEV 1、DLco增加207.8 ± 372.2 mL（p > 0.05），107.8 ± 295.2 mL（p > 0.05）和0.7 ± 6.0 mL/min/mmHg（p > 0.05），而对照组则降低（383.3 ± 536.7; 215.6 ± 228.9; 1.4 ± 1.7）。观察组治疗后咳嗽、咳痰、呼吸困难、胸闷、胸痛等临床症状的发生率较治疗前下降（均p < 0.05），对照组治疗后上述症状的发生率较治疗前上升，但变化无统计学意义（均p > 0.05）。汉防己甲素可控制和延缓AS相关性矽肺纤维化的进展，改善胸部HRCT成像和肺功能。
Outbreaks of silicosis have occurred among workers in the artificial stone (AS) industry, and there is currently no effective antifibrosis treatment for silicosis. A retrospective cohort study. We retrospectively analyzed the clinical data of 89 artificial stone-associated silicosis patients treated in Shanghai Pulmonary Hospital (China). Patients who agreed to be administered tetrandrine entered the observation group and those who disagreed entered the control group. Changes in chest HRCT, pulmonary function, and clinical symptoms of patients in two groups were compared pre- and post-treatment. After treatment for 3–12 months, 56.5%–65.4% of patients in the observation group showed improvements in HRCT imaging, while there was no improvement in the control group (p < 0.05). Disease progression occurred in 0%–17.4% of patients in the observation group after 3–12 months of treatment compared with 44.4%–92.0% of patients in the control group (p < 0.05). After 3 months of treatment, the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and diffusing capacity of the lung for carbon monoxide (DLco) in the observation group increased by 136.7 ± 189.2 mL (p < 0.05), 124.2 ± 169.9 mL (p < 0.05), and 1.4 ± 2.3 mL/min/mmHg (p > 0.05), respectively, while those in the control group decreased (145.8 ± 356.5; 107.5 ± 272.1; 1.9 ± 3.8). After 6 months of treatment, FVC, FEV1, and DLco in the observation group increased by 207.8 ± 372.2 mL (p > 0.05), 107.8 ± 295.2 mL (p > 0.05) and 0.7 ± 6.0 mL/min/mmHg (p > 0.05), respectively, while those of the control group decreased (383.3 ± 536.7; 215.6 ± 228.9; 1.4 ± 1.7). The incidences of clinical symptoms such as cough, expectoration, dyspnea, chest tightness, and chest pain in the observation group were decreased-after treatment (all p < 0.05), while the incidences of these symptoms increased in the control group, although the change was not statistically significant (all p > 0.05). Tetrandrine can control and delay the progression of AS-associated silicosis fibrosis, with improved chest HRCT imaging and pulmonary function.