目的 分析糖皮质激素联合N-乙酰半胱氨酸、大环内酯类对慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）伴间质性肺炎的疗效及安全性。方法 选取2014年3月-2017年3月我院收治的COPD伴间质性肺炎患者 59例，按照随机数字表法分为对照组（27例）和观察组（32例），对照组予以常规氧疗、糖皮质激素、止咳化痰、 抗炎等治疗，观察组在此基础上联合N-乙酰半胱氨酸、阿奇霉素治疗，对比分析两组患者临床疗效及不良反应发生 情况。结果 观察组总有效率93.75%显著于对照组74.07%（P<0.05）。观察组总不良反应率15.63%与对照组25.93% 相比较（P>0.05）。结论 糖皮质激素联合N-乙酰半胱氨酸、大环内脂类对COPD伴间质性肺炎的疗效显著，且不增 加药物不良反应，安全性高。

Objective To investigate the curative effect and safety of glucocorticoid combined with N-Acetyl-L-cysteine, macrolides on COPD with ILD. Methods 59 cases of COPD with ILD in our hospital from March 2014 to March 2017 were selected and divided randomly into control group (27 cases) and observation group (32 cases), control group was given conventional oxygen cure, glucocorticoid, cough phlegm, anti-inflammatory, observation group was given N-Acetyl-L-cysteine, azithromycin on this basis, clinic effect, adverse reactions of the two groups were compared. Results Total efficiency of observation group (93.75%) was significantly higher than control group (74.07%) (P<0.05). Total adverse reaction rate of observation group (15.63%) was lower than control group (25.93%) (P>0.05). Conclusion Glucocorticoid combined with N-Acetyl-L-cysteine, macrolides has significantly effect on COPD with ILD, adverse reactions will not increase and the safety is higher.