摘要
目的探讨呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)在评估慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者气道慢性炎症及糖皮质激素治疗效果中的价值。方法 COPD患者101例,依据慢性阻塞性肺疾病全球倡议(Global Initiative for Chronic Obstructive Lung Disease,GOLD)分级分为轻度组9例、中度组35例、重度组36例、极重度组21例,同期25例体检健康者为对照组,检测并比较其FeNO水平;比较合并哮喘(32例)与未合并哮喘(69例),应用糖皮质激素(57例)与未应用糖皮质激素(44例),从未吸烟(42例)与未戒烟(23例)及已戒烟(36例)COPD患者FeNO增高率。结果COPD组患者FeNO水平[(15.51±13.23)ppb]明显高于对照组[(11.20±8.30)ppb](P<0.05);COPD轻度组[(12.6±8.2)ppb]、中度组[(17.5±12.1)ppb]、重度组[(15.7±11.5)ppb]、极重度组[(13.0±7.6)ppb]FeNO水平比较差异无统计学意义(P>0.05);合并哮喘者FeNO增高率(21.9%)明显高于未合并哮喘者(7.2%)(P<0.05);未应用糖皮质激素治疗者FeNO增高率(20.5%)明显高于应用糖皮质激素治疗者(5.3%)(P<0.05);从未吸烟、未戒烟、已戒烟者FeNO增高率比较差异无统计学意义(P>0.05)。结论 FeNO可较好反映Th2介导的气道慢性炎症,有助于评价糖皮质激素治疗效果,可能有助于COPD合并支气管哮喘重叠综合征的诊断。
Objective To explore the value of detection of fractional exhaled nitric oxide （FeNO） levels to evaluating chronic airway inflammation in patients with chronic obstructive pulmonary disease （COPD） and the effect of glucocorticoid. Methods According to the Global Initiative for Chronic Obstructive Lung Disease （GOLD）, 101 patients with COPD were divided into mild group （n= 9）, moderate group （n＇= 35）, severe group （n=36） and extremely severe group （n=21）. Another 25 healthy volunteers were as controls （control group）. The FeNO levels were detected and compared among groups. The increased rates of FeNO were compared between asthma patients （n=32） and non-asthma patients （n=69）, between patients receiving glucocorticoid （n=57） and receiving no glucocorticoid （n=44）, among patients never smoking （n=42）, smokers （n=23） and ex-smokers （n=36）, respectively. Results The FeNO level in COPD patients （（15.5±13.2） pph） was significantly higher than that in control group （（11.2±8.3） ppb） （P〈0.05）, and there were no significant differences in the FeNO levels among mild group （（12. 6±8.2） ppb）, moderate group （（17.5±12.1） pph）, severe group （（15.7±11.5） ppb） and extremely severe group （（13.0±7.6） ppb） （P〉0.05）. The increased rate of FeNO was significantly higher in asthma patients （21.9%） than that in non-asthma group （7.2 %） （P〈0.05）, higher in patients receiving glucocorticoid （20.5%） than that in patients not receiving glucocorticoid （5.3%） （P〈0.05）, and there were no significant differences among patients never smoking, smokers and ex-smokers （P〉 0.05）. Conclusion FeNO is a good biomarker for airway inflammation, contributing to the evaluation of the effect of glucocorticoid and the diagnosis of asthma COPD overlap syndrome.
出处
《中华实用诊断与治疗杂志》
2016年第5期503-505,共3页
Journal of Chinese Practical Diagnosis and Therapy
关键词
慢性阻塞性肺疾病
呼出气一氧化氮
哮喘
糖皮质激素
吸烟
Chronic obstructive pulmonary disease
fractional exhaled nitric oxide
asthma
glucocorticoid
smoking
