N-乙酰半胱氨酸治疗COPD合并肺结核临床观察

目的：评价N-乙酰半胱氨酸（NAC）对慢性阻塞性肺疾病（COPD）合并肺结核患者肺功能、细胞免疫功能和生活质量的影响。方法：93例患者随机分为对照组47例和观察组46例,对照组予常规治疗,观察组加服NAC,6个月为一个疗程。比较抗结核作用、肺功能、细胞免疫功能和生活质量,记录不良反应。结果：治疗后,与对照组相比,观察组肺功能指标FEV₁/FVC和PEF,CD4+T、CD4+Foxp3+调节性T细胞亚群比例明显升高,CD4+/CD8+和SGRQ问卷中症状、活动、影响维度评分明显降低,组间均有显著性差异（P<0.05）。其余指标组间无差异。结论：NAC可明显改善COPD合并肺结核患者的肺功能、细胞免疫功能和生活质量,值得临床推广。

Clinical observation of N-acetyl cysteine for COPD complicated with pulmonary tuberculosis

OBJECTIVE To evaluate the impact of N-acetyl cysteine (NAC) on the pulmonary function, cellular immunity and quality of life of patients with COPD complicated with pulmonary tuberculosis.METHODS 93 patients were randomly divided into control group (47 cases) and study group (46 cases).The control group received conventional treatment, and the study group was given an addition of NAC. Both groups were treated for 6 months. The anti-tuberculosis treatment effect, pulmonary function, cellular immunity function and quality of life were compared, and the adverse reactions were recorded.RESULTS After treatment, compared with the control group, the pulmonary function index FEV1/FVC and PEF, CD4+ T, CD4+Foxp3+ regulatory T cell subset ratio in the observation group were significantly increased, and the symptom, activity, and impact dimension scores in the CD4+/CD8+ and SGRQ questionnaires were significantly lower, with statistical differences between the groups (P<0.05).There were no differences in the remaining indexes between groups. CONCLUSION NAC could significantly improve the pulmonary function, cellular immunity and quality of life of patients with COPD complicated with pulmonary tuberculosis, and is worthy of wide spread in clinical use.