【摘要】 目的 探究N-乙酰半胱氨酸（NAC）联合氨溴索对初治肺结核患者转归及血清白细胞介素-23(IL-23)、核因子E2相关因子2(Nrf2)水平的影响。方法 选取2021年1月至2022年1月收治的102例初治肺结核患者，随机分为单药组（n=51）和联合用药组（n=51）。单药组在常规治疗基础上采用氨溴索治疗，联合用药组在常规治疗的基础上采用NAC联合氨溴索治疗。比较2组肺结核患者治疗前后用力肺活量（FVC）、第1秒用力呼容积（FEV1）、FEV1/FVC、血清IL-23、Nrf2的水平，并比较2组治疗后痰菌转阴率、病灶吸收率及临床疗效。结果 与治疗前比较，治疗后2组肺结核患者FVC、FEV1、FEV1/FVC明显升高（P <0.05），且联合用药组均高于单药组（P <0.05）；治疗后2组肺结核患者血清IL-23、Nrf2水平明显降低（P <0.05），且联合用药组低于单药组（P <0.05）；治疗后，联合用药组痰菌转阴率、病灶吸收率及临床疗效均高于单药组（P <0.05）。结论 NAC联合氨溴索能够促进初治肺结核患者转归，改善患者肺功能、抑制氧化应激、减轻炎症反应，疗效较好。更多还原

【Abstract】 AIM To investigate the impacts of N-acetylcysteine(NAC) combined with ambroxol on the outcome and serum interleukin-23(IL-23) and nuclear factor E2 related factor 2(Nrf2) levels in newly diagnosed pulmonary tuberculosis patients. METHODS A total of 102 patients with newly treated pulmonary tuberculosis admitted from January 2021 to January 2022 were divided into single drug group(n=51) and combined drug group(n=51). On the basis of routine treatment, the single drug group was treated with ambroxol, and the combined drug group was treated with NAC combined with ambroxol. The forced vital capacity(FVC), forced expiratory volume in the first second(FEV1),FEV1/FVC, serum IL-23 and Nrf2 levels were compared between 2 groups before and after treatment, and the sputum negative rate, focal absorption rate and clinical efficacy were compared between 2 groups. RESULTS Compared with before treatment, the FVC, FEV1 and FEV1/FVC in patients with pulmonary tuberculosis in 2 groups increased obviously after treatment(P < 0.05), the combination group were higher than the single drug group(P < 0.05). The levels of serum IL-23 and Nrf2 in patients with pulmonary tuberculosis in 2 groups decreased obviously after treatment(P <0.05), and the combined drug group were lower than the single drug group(P < 0.05). Compared with the single drug group, the sputum negative conversion rate, focus absorption rate and clinical efficacy of the combined drug group were obviously higher after treatment(P < 0.05). CONCLUSION NAC combined with ambroxol can promote the outcome of newly treated pulmonary tuberculosis patients, improve their pulmonary function, inhibit oxidative stress, reduce inflammatory reaction, and have a good effect.更多还原