摘要
目的:探究一氧化氮(FeNO)检测在指导慢性阻塞性肺疾病(COPD)治疗中应用糖皮质激素的价值。方法:2018年12月-2019年12月收治COPD患者62例,随机分为两组,各31例。A组先给予糖皮质激素治疗,B组给予安慰剂治疗;治疗10 d后停药,经过28 d后进行第2轮治疗,此时B组给予糖皮质激素治疗,A组给予安慰剂治疗;治疗10 d后停药。并在治疗前对患者进行FeNO检测,以30 ppb为FeNO切点值,根据FeNO值对患者重新分组。测定治疗前,首次用药后,第2次用药后患者FeNO值,6 min步行距离。结果:两组使用糖皮质激素治疗后,FeNO值及6 min步行距离均优于治疗前,差异有统计学意义(P<0.05);两组患者在使用安慰剂治疗后,FeNO值及6 min步行距离与用药前比较,差异均无统计学意义(P>0.05)。结论:对于FeNO<30 ppb的患者,糖皮质激素的治疗效果较差,可以考虑减少或者避免糖皮质激素的使用,以减少不良反应。
Objective:To explore the value of FeNO detection in guiding the application of glucocorticoids in the treatment of COPD.Methods:From December 2018 to December 2019,62 patients diagnosed with COPD were selected,they were randomly divided into the two groups with 31 cases in each group.The group A was first treated with glucocorticoids.The group B was given placebo.The treatment was discontinued after 10 days of treatment,and a second round of treatment was given after 28 days.At this time,the group B was given glucocorticoids.The group A was given placebo.The drug was stopped after 10 days of treatment.The patients were tested for FeNO before treatment,and the patients were re-grouped according to the Feno value with 30 ppb as the FeNO"tangent"value.The Feno value and 6 min walking distance of the patients were measured before treatment,after the first medication and after the second medication.Results:The FeNO value and 6-min walking distance of the two groups after treatment with glucocorticoid were better than those before treatment,the difference was statistically significant(P<0.05).After patients were treated with placebo,there was no statistically significant difference in FeNO value and 6-minute walking distance from before treatment(P>0.05).Conclusion:The therapeutic effect of glucocorticoid is poor in patients with FeNO<30 ppb.It can be considered to reduce or avoid the use of glucocorticoid in order to reduce adverse reactions.
作者
程明康
陈英吉
房晓鹏
Cheng Mingkang;Chen Yingji;Fang Xiaopeng(Department of Respiratory Medicine,Songyuan Jilin Oilfield Hospital,Jilin Songyuan 138000)
出处
《中国社区医师》
2020年第30期21-22,共2页
Chinese Community Doctors
