摘要
目的观察不同程度老年慢性阻塞性肺疾病(COPD)病人呼出气一氧化氮(FeNO)水平的变化,并探讨其与炎症及肺功能指标的相关性。方法选取急性加重期COPD(AECOPD)病人50例、稳定期COPD病人50例,对所有病人治疗前后的外周血嗜酸性粒细胞(Eos)和中性粒细胞(N)、FeNO、第1秒用力呼气容积(FEV1)及FEV1占预计值百分比(FEV1%pred)进行检测,同时选取50名健康体检者作为正常对照组。分析FeNO水平的变化情况及其与炎症、肺功能指标的相关性。结果AECOPD组FeNO、Eos、N水平与稳定期COPD组比较明显升高,差异有统计学意义,稳定期COPD组与正常对照组比较,差异亦有统计学意义(P<0.05)。AECOPD组组内比较,GOLD 3～4级组与GOLD 1～2级组比较,FeNO水平降低,Eos及N升高,差异有统计学意义(P<0. 05)。GOLD 3～4级的AECOPD组病人在糖皮质激素治疗后FeNO、Eos、N水平明显下降(P<0. 05)。结论 FeNO水平在COPD病人中升高,特别是COPD急性加重期显著升高,有助于评价气道炎症,但不能反映COPD病情的严重程度; AECOPD病人经糖皮质激素治疗后,FeNO水平下降,提示FeNO有助于评价糖皮质激素的疗效并指导治疗。
Objective To observe the changes of the level of exhaled nitric oxide(FeNO)in the elderly patients with different degrees of chronic obstructive pulmonary disease(COPD),and to investigate its correlation with inflammation and pulmonary function indicators.Methods The study enrolled 50 cases of stable COPD as stable COPD group and 50 cases of acute exacerbation COPD(AECOPD)as AECOPD group,50 healthy people as the control group.The levels of peripheral blood eosinophil(Eos)and neutrophil(N),FeNO,forced expiratory volume in one second(FEV1)and FEV1%pred were compared among the three groups.Results The levels of FeNO,Eos,N were significantly higher in the AECOPD group than those in the stable COPD group,and were significantly higher in the stable COPD group than those in the healthy control group(P<0.05).In AECOPD group,the patients with GOLD 3-4 presented with lower level of FeNO,higher level of EOS and N than those patients with GOLD 1-2(P<0.05).After the treatment of glucocorticoid,the levels of FeNO,Eos,N levels were significantly decreased in the patients with GOLD 3-4(P<0.05).Conclusions The level of FeNO increases in the patients with COPD,especially during the acute intensification period,which help to evaluate the airway inflammation.The treatment of glucocorticoid could decrease the level of FeNO,which suggests that FeNO might be helpful in evaluating the efficacy of glucocorticoid and guiding the treatment.
作者
周薇
彭红星
ZHOU Wei;PENG Hong-xing(Department of Respiratory Medicine,Liyuan Hospital of Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430077,China)
出处
《实用老年医学》
CAS
2019年第3期237-240,共4页
Practical Geriatrics
关键词
慢性阻塞性肺疾病
呼出气一氧化氮
糖皮质激素
肺功能
chronic obstructive pulmonary disease
exhaled nitric oxide
glucocorticoid
lung function
