N-乙酰半胱氨酸雾化吸入治疗急性鼻窦炎的临床疗效

目的　观察N-乙酰半胱氨酸雾化吸入治疗急性鼻窦炎的疗效，及其对机体炎性因子和免疫因子的影响。方法　选取急性鼻窦炎患者164例，采用随机数字表法分为试验组和对照组，每组82例。对照组采用常规药物治疗，试验组采用常规药物联合N-乙酰半胱氨酸雾化吸入治疗。治疗前后，采用化学发光标记免疫分析法检测血清肿瘤坏死因子（TNF）-α和白细胞介素（IL）-6、IL-8、IL-10，免疫速率散射比浊法检测血清免疫球蛋白组（IgG、IgA、IgM）；并评价各症状视觉模拟量表评分（VAS）、鼻内镜检查Lund-Kennedy评分及治疗效果。结果　与治疗前相比，2组患者治疗后TNF-α、IL-6、IL-8、IL-10水平明显降低，IgG、IgA、IgM水平升高，VAS、Lund-Kennedy评分明显降低，且试验组上述指标变化均较对照组显著（P＜0.05）。试验组治疗总有效率明显高于对照组（P＜0.05）；治疗期间所有患者均未出现恶心、呕吐、皮疹、瘙痒等不良反应，无眶内感染、视神经炎、失明、颅内感染等并发症发生。结论　采用N-乙酰半胱氨酸雾化吸入治疗急性鼻窦炎安全有效，值得临床推广应用。

Clinical efficacy of inhaled N-acetylcysteine in the treatment of acute sinusitis

Objective　To observe the effect of inhaled N-acetylcysteine nebulization in patients with acute sinusitis, and its influence on the inflammatory factors and immune factors. Methods　A total of 164 patients with acute sinusitis were selected and divided into experimental group (n=82) and control group (n=82) by random number table. The control group was treated with conventional drugs, and the experimental group was treated with conventional drugs combined with N-acetylcysteine nebulized inhalation. Chemical luminescent immunoanalysis was used for the detection of serum levels of TNF-α, IL-6, IL-8 and IL-10 before and after treatment. The scattering immunoturbidimetric assay was used for the detection of immune factor levels (IgG, IgA and IgM). The visual analogue scale (VAS) scores, Lund-Kennedy scores in nasal endoscopy and treatment effect were also compared between the two groups of patients. Results　Compared with before treatment, the levels of TNF-α, IL-6, IL-8 and IL-10 in the two groups were significantly reduced, the levels of IgG, IgA, and IgM were increased, and the scores of VAS and Lund-Kennedy were significantly reduced. The changes of the above indicators in the group were more significant than those in the control group (P＜0.05). The total effective rate of treatment in the experimental group was significantly higher than that in the control group (P＜0.05). During the treatment period, all patients had no adverse reactions such as nausea, vomiting, rash, pruritus, and no complications such as intraorbital infection, optic neuritis, blindness, intracranial infection, etc. Conclusion　The inhalation of N-acetylcysteine in the treatment of acute rhinosinusitis is safe and effective, and which is worthy of clinical promotion and application.