摘要
目的:研究呼出气一氧化氮(FeNO)检测对哮喘-慢性阻塞性肺疾病(COPD)重叠综合征(ACOS)患者的临床意义。方法:以2014年4月-2015年11月在我院就诊的COPD患者为研究对象,根据其表型分为单纯COPD组46例和ACOS者(42例),同时选取健康体检者30例作为对照组。观察三组研究对象FeNO、诱导痰细胞计数、血清超敏C反应蛋白(hs-CRP)、血清白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)水平的差异,分析ACOS患者FeNO水平与诱导痰细胞计数、hs-CRP、IL-8、TNF-α的相关性。结果:三组研究对象之间性别构成、体重、身高与吸烟量无统计学差异。与单纯COPD组进行比较,ACOS组患者FeNO水平与痰嗜酸粒细胞计数明显增高或增多(P<0.05);痰细胞总数、hs-CRP、IL-8与TNF-α则没有统计学差异。与健康对照组比较,ACOS组FeNO水平、痰细胞总数、痰嗜酸粒细胞计数、hs-CRP、IL-8与TNF-α均明显增高或增多(P<0.05);单纯COPD组痰细胞总数、hs-CRP、IL-8及TNF-α均明显增多或增高,有明显统计学差异,P<0.05,而FeNO与痰嗜酸粒细胞计数则没有统计学差异。ACOS组患者FeNO与痰嗜酸粒细胞计数呈正相关,r=0.387,P<0.05;与痰细胞总数、FEV1%、FEV1/FVC%、及血清hs-CRP、IL-8、TNF-α之间的相关性均无统计学意义,r=0.264,0.286,0.301,0.238,0.203,0.226,均P>0.05。结论:ACOS患者的气道炎症与嗜酸粒细胞有一定关系。FeNO检测从一定程度反映了ACOS患者的气道炎症,能够从COPD人群中识别出ACOS患者。
Objective：To study the significance of measuring fractional exhaled nitric oxide in patients with asthma-chronic obstructive pulmonary disease overlap syndrome（ACOS）.Methods：A total of 88 patients with stable COPD and 30 healthy subjects were recruited into the study.All the patients were divided into chronic obstructive pulmonary disease（COPD）only group（46cases）and ACOS group（42cases）.Induced sputum cell counts,serumhign sensitivity C relative protein（hsCRP）,serum interleukin 8（IL-8）and tumor necrosis factor-α（TNF-α）were detected in the levels of three groups of subjects,and the correlation were analyzed between FeNO and induced sputum cell counts,hs-CRP,IL-8and TNF-αin patients with ACOS.Results：Compared with that re-spectively in COPD only group,the level of FeNO and sputum eosinophils count in ACOS group was significantly increased（P0.05）,while there were no significant differences in the total number of sputum cells,hs-CRP,IL-8and TNF-αbetween two groups（P0.05）.The level of FeNO,the total number of sputum cells,sputum eosinophils count,hs-CRP,IL-8and TNF-αin ACOS group were significantly higher than that of healthy control group（P0.05）,while the level of total number of sputum cell counts,hs-CRP,IL-8and TNF-αin COPD only group were significantly higher than that of healthy control group（P0.05）.But there were no statistically significant differences between the COPD only group and healthy control group in FeNO and sputum eosinophils count（P0.05）.FeNO in patients with ACOS group was positively correlated with sputum eosinophils count（r=0.387,P0.05）,but was not correlated with total number of sputum cells,FEV1%,FEV1/FVC%,serum hs-CRP,IL-8and TNF-α（respectively r=0.264,0.286,0.301,0.238,0.203,0.226,all P0.05）.Conclusion：Airway inflammation in patients with ACOS has a certain relationship with eosinophils.Measuring FeNO can be used as a useful method of indentifing ACOS from COPD.
出处
《武汉大学学报（医学版）》
CAS
2016年第6期938-941,945,共5页
Medical Journal of Wuhan University
基金
国家科技支撑计划资助项目(编号:201113AI11B12)
关键词
慢性阻塞性肺疾病
呼出气一氧化氮
诱导痰
炎症
肺功能
Chronic Obstructive Pulmonary Disease
Fractional Exhaled Nitricoxide
Induced Sputum
Inflammation
Pulmonary Function
