摘要
目的评估呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)在支气管哮喘管理中的作用。方法选取未规范使用控制药物的哮喘患者25例,给予为期12周的布地奈德(200μg,bid)吸入治疗,检测治疗前后的FeNO水平、肺功能、ACT评分、血常规、血清总IgE以及诱导痰。同期选取25例健康受试者,给予检测FeNO水平。结果哮喘组患者吸入布地奈德治疗后的FeNO水平(体积分数)较治疗前显著降低[(49.98±25.98)×10-9 vs.(109.18±65.23)×10-9,P=0.000]。治疗前的FeNO水平明显高于健康对照组[(109.18±65.23)×10-9 vs.(12.44±4.31)×10-9,P=0.000],治疗后的FeNO水平也明显高于健康对照组[(49.98±25.98)×10-9 vs.(12.44±4.31)×10-9,P=0.000)]。治疗后的FEV1/pred较治疗前显著改善[(83.40%±15.74%)vs.(72.45%±7.48%),P=0.002];治疗后的ACT评分显著高于治疗前(22.88±1.81 vs.14.88±4.21,P=0.000);治疗后的血嗜酸性粒细胞百分比(Eos%)明显低于治疗前[(4.33%±1.89%)vs.(5.70%±1.85%),P=0.004];治疗后的血清总IgE显著低于治疗前[(231.35±200.59)ng/mL vs.(284.81±231.12)ng/mL,P=0.004];治疗后的诱导痰Eos%明显低于治疗前[(6.58%±3.66%)vs.(10.00%±4.75%),P=0.004]。治疗前的FeNO水平与ACT评分呈显著负相关(r=-0.425,P=0.034),与诱导痰Eos%呈显著正相关(r=0.657,P=0.020)。结论 FeNO水平是一种用于评估气道嗜酸粒细胞性炎症的可行性指标,其有助于评估哮喘的控制情况。
Objective To evaluate the roles of fractional exhaled nitric oxide （FeNO） in the management of bronchial asthma. Methods Twenty-five asthmatic patients without standard medication treatment were recruited. Budesonide （200μg,bid） was used for twelve weeks to evaluate the changes of FeNO level, pulmonary functions, ACT scores, blood routine tests, total serum IgE and cell counts in induced sputum. At the same time, Twenty-five healthy people were recruited as control group and their FeNO levels were tested. Results After treated with Budesonide,the FeNO levels （volume fraction） of asthmatic patients were significantly lower than those before treatment [（49.98 ＋25.98）×10^-9 vs. （109. 18±65.23） ×10^-9 ,p= 0. 000]. Meanwhile,the FeNO levels of asthmatic patients were markedly higher than those of controllers＇ before treatment [（109. 18±65.23） ×10^9 vs. （12. 44±4.31 ×10^9 ,P=0.000],and after trented[（49.98±25.98）×10^9 vs. （12.44＋4.31） ×10^9 ,P=0.000）] . After treatment with Budesonide,the FEV1/pred levels [（83.40%±15.74%） vs. （72.45% ±7.48% ,） P= 0. 002], the ACT scores [22.88 ±1.81 vs. 14. 88±4. 21 ,P = 0. 000] of asthmatic patients were significantly higher than their pre-treatment levels;the eosinophil percentage （Eos%） counts in blood routine test E（4. 33% ± 1. 89%） vs. （5.70%±1.85%） ,P = 0. 004] ,the total serum IgE [（231.35±200. 59） ng/mL vs. （284. 81±231.12） ng/ mL,P= 0.004],the Eos% in induced sputum [（6. 58%±3.66%） vs. （10.00%± 4. 75%） ,P = 0. 0041 were significantly lower than their pre-treatment levels. The FENO levels before treatment were significant negatively correlated with the ACT scores （r =- 0. 425 ,P = 0. 034） and significant positively correlated with the Eos% in induced sputum （r = 0. 657, P = 0. 020）. Conclusions FeNO level may be a good parameter for the management of eosinophlic airway inflammation. It may bring benefit to evaluate asthma management.
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2013年第3期349-353,共5页
Fudan University Journal of Medical Sciences
基金
上海市重点学科建设项目(B115)
中央高校基本科研业务费专项基金项目(10FX088)~~
