摘要
目的:探讨FeNO测定对指导慢性阻塞性肺疾病(COPD)稳定期患者合理选用吸入性糖皮质激素的临床预测价值。方法:纳入2016年1月~2017年1月于广东省中西医结合医院门诊就诊的COPD稳定期患者144例,按随机数字法,随机分成FeNO正常组和偏高组各72例,每组再随机分成ICS+LAMA亚组和LAMA亚组各36例,疗程3个月,观察四组治疗前后及1年随访后急性加重次数、临床疗效、肺功能、治疗费用等变化情况。结果:FeNO正常组中使用LAMA、ICS+LAMA在肺功能改善、生活质量评分(CAT、mMRC)、FeNO改善水平、治疗费用、急性加重次数等方面未见明显优势,差异无统计学意义(P>0.05);而在FeNO偏高组,采用ICS+LAMA对COPD患者肺功能改善、生活质量提高、气道慢性炎性反应减轻及治疗花费的降低均存在显著优势,差异有统计学意义(P<0.05)。结论:对于FeNO偏高的COPD患者,联合使用ICS疗效更佳。
Objective To investigate the value of inhalation glucocorticoid therapy guide by fractional exhaled nitric oxide (FeNO) in patients with chronic obstructive pulmonary disease (COPD).Method Totally 144 elderly patients with COPD in Guangdong TCM and Western Medicine Hospital form January 2016 to January 2017 were measured with FeNO testing and pulmonary function test,and allocated either into the low or the high FeNO group depending on their FeNO level.The two groups then were divided into two subgroubs by treating with LAMA alone or combimed with inhaled corticosteroid (ICS) for 3 months,the FeNO test,pulmonary function test,CAT score,mMRC grade were compared between the four groups.The therapeutic effect,cost of treatment and the number of acute exacerbation correlated with COPD in a year were compared and analyzed at the end of this study.Results In low FeNO group,both the FeNO values,pulmonary function test,CAT score,mMRC grade,therapeutic effect,cost of treatment and the number of acute exacerbation showed no statistical difference before and after treatment in each subgroups (P>0.05).In high FeNO group,the FeNO values after treatment was significantly lower than that before treatment;the improvement of lung function,CAT score,mMRC grade,therapeutic effect,cost of treatment and the number of acute exacerbation waere significantly better than other three subgroups in the high FeNO ICS+LAMA subgroup (P<0.05). Conclusion The treatment of ICS+LAMA for COPD patients with high FeNO was effective.
作者
戴勇
曾崎冈
DAI Yong;ZENG Qi-gang(Department of respiratory medicine,Guangdong Hospital of integrated traditional Chinese and Western medicine,Foshan 528200,China)
出处
《吉林医学》
CAS
2019年第6期1203-1207,共5页
Jilin Medical Journal
基金
佛山市医学类科技攻关项目[项目编号:2015AB000822]
关键词
呼出气一氧化氮
慢性阻塞性肺疾病
吸入性糖皮质激素
Fraction of exhaled nitric oxide
Chronic obstructive pulmonary disease
Inhaled corticosteroid
