目的 探討低分子肝素聯(lián)合環(huán)磷酰胺治療特發(fā)性間質(zhì)性肺炎的臨床療效。方法 選取天津市海河醫(yī)院2014年10月—2015年10月收治的特發(fā)性間質(zhì)性肺炎患者60例，隨機(jī)分為對(duì)照組（30例）和治療組（30例）。對(duì)照組患者口服環(huán)磷酰胺片，25 mg/次，1次/d，每周增加25 mg，最大量150 mg/d，每治療2周休息2周；治療組治療組在對(duì)照組的基礎(chǔ)上皮下注射低分子肝素鈣注射液，5000 U/次，2次/d，每個(gè)月注射前兩周，兩組均治療4個(gè)月。治療后，觀察兩組臨床-影像-生理評(píng)分（CRP）評(píng)分、動(dòng)脈血氧分壓（pO₂）和肺活量（VC）、血漿白介素-6（IL-6）和血清腫瘤壞死因子-α（TNF-α）水平以及治療中不良反應(yīng)發(fā)生情況。結(jié)果 治療后，兩組的臨床評(píng)分和生理評(píng)分均比治療前顯著降低（P<0.05），且治療組降低的更為明顯，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組患者pO₂和VC均有所提高，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。且治療后治療組的pO₂和VC明顯高于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組的IL-6和TNF-α均較治療前顯著降低（P<0.05），且治療組較對(duì)照組降低更為明顯，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療組和對(duì)照組不良反應(yīng)率分別為3.33%、16.67%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 低分子肝素聯(lián)合環(huán)磷酰胺治療特發(fā)性間質(zhì)性肺炎患者臨床效果顯著，且不良反應(yīng)少，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To observe the clinical effect of low molecular heparin combined with cyclophosphamide in treatment of idiopathic interstitial pneumonia. Methods Patients (60 cases) with idiopathic interstitial pneumonia in Tianjin Haihe Hospital from October 2014 to October 2015 were randomly divided into control (30 cases) and treatment (30 cases) groups. Patients in control group were po administrated with Cyclophosphamide Tablets, 25 mg/time, once daily, increasing 25 mg every week, and the maximum dosage was 150 mg/d. They were treaed for 2 weeks and another 2 weeks for rest. Patients in the treatment group were sc administrated with Low Molecular Weight Heparin Calcium Injection on the basis of control group, 5000 U/time, twice daily, and injection in the first two weeks of each month. The patients in two groups were treated for 4 months. After treatment, CRP scores, pO₂ and VC, IL-6 and TNF-α, and adverse reaction between two groups were compared. Results After treatment, clinical and physiological scores in two groups were diminished more than those before treatment (P<0.05), and the two scores in the treatment group decreased more obviously than those in the control group, with significant difference between two groups (P<0.05). pO₂ and VC in two groups were higher than those before treatment, and the differences were statistically significant in the same group (P<0.05). And pO₂ and VC in the treatment group were higher than those in control group with significant difference between two groups (P<0.05). The levels of IL-6 and TNF-α in two groups were lower than those before treatment (P<0.05), and the observational indexes in the treatment group decreased more obviously than those in the control group with significant difference (P<0.05). The adverse reaction rates in the treatment and control groups were 3.33% and 16.67%, respectively, and there were significant difference between two groups (P<0.05). Conclusion Low molecular heparin combined with cyclophosphamide has a significant clinical effect in treatment of idiopathic interstitial pneumonia with little adverse reaction, which has a certain clinical application value.