摘要
目的研究呼出气一氧化氮(FeNO)评估慢性阻塞性肺疾病(COPD)患者气道慢性炎症和糖皮质激素治疗效果的临床价值。方法回顾性研究。选取2016年10月至2018年9月在日照市妇幼保健院和日照市人民医院住院治疗的120例COPD患者, 其中包括急性加重期COPD患者60例(急性加重期组), 稳定期COPD患者60例(稳定期组), 并选择同期在日照市妇幼保健院体检的健康者60名作为对照组, 比较不同组别的FeNO浓度、肺功能及痰嗜酸粒细胞计数指标;给予COPD患者短期糖皮质激素治疗后, 比较急性加重期组及稳定期组患者治疗前后的相关指标变化情况, 并分析FeNO与患者肺功能变化的相关性。结果急性加重期组及稳定期组患者的FeNO水平均明显高于对照组(P值均<0.05);治疗后, 急性加重期组及稳定期组患者的肺功能指标较治疗前明显升高(P值均<0.05);FeNO及痰嗜酸粒细胞计数水平较治疗前明显降低(P值均<0.05);急性加重期组及稳定期组患者的治疗前后的FeNO水平与治疗前后的肺功能指标无相关性(P值均>0.05), 但急性加重期组及稳定期组治疗前的FeNO水平与治疗后的第1秒用力呼气容积的改善值均呈正相关(P值均<0.05)。结论 FeNO能有效反映COPD患者气道炎症程度, 动态监测患者FeNO水平可作为评估患者应用糖皮质激素治疗效果的重要指标, 对患者临床治疗方案的制订具有参考价值。
Objective To evaluate the clinical value of fraction exhaled nitric oxide(FeNO)in the treatment of chronic airway inflammation with glucocorticoid in patients with chronic obstructive pulmonary disease(COPD).Methods This was a retrospective study.A total of 120 COPD patients hospitalized in Rizhao Maternal and Child Health Hospital and Rizhao People′s Hospital from October 2016 to September 2018 were selected,including 60 patients with acute exacerbation of COPD(acute exacerbation group)and 60 patients with stable COPD(stable group).Sixty healthy people who underwent physical examination in Rizhao Maternal and Child Health Hospital during the same period were selected as control group.FeNO concentration,pulmonary function,and phlegm eosinophilia in different groups were compared.After short-term glucocorticoid treatment in COPD patients,the related indicators before and after treatment in the acute exacerbation group and the stable stage group were compared,and the correlation between FeNO and changes in lung function of patients was analyzed.Results The levels of FeNO in acute exacerbation group and stable group were significantly higher than that in control group(both P<0.05).After treatment,the lung function indexes in acute exacerbation group and stable group were significantly higher than those before treatment(all P<0.05).FeNO and eosinophil count in sputum were significantly lower than before treatment(all P<0.05).There was no significant correlation between the level of FeNO and pulmonary function before and after treatment in patients with acute exacerbation and stable COPD(all P>0.05),but FeNO level before treatment was positively correlated with the improved value of forced expiratory volume in the first second after treatment in both the acute exacerbation group and stable COPD patients(both P<0.05).Conclusions FeNO can effectively reflect the degree of airway inflammation in patients with COPD,and dynamic monitoring of FeNO level can be used to evaluate the therapeutic effect of glucocorticoid,whic
作者
厉光锋
张守菊
刘涛
Guangfeng Li;Shouju Zhang;Tao Liu(Department of Internal Medicine,Rizhao Maternal and Child Health Hospital,Rizhao 276826,China;Department of Respiratory and Critical Care Medicine,Rizhao People′s Hospital,Rizhao 276826,China)
出处
《国际呼吸杂志》
2021年第22期1746-1750,共5页
International Journal of Respiration
关键词
肺疾病
慢性阻塞性
糖皮质激素类
呼出气一氧化氮
Pulmonary disease,chronic obstructive
Glucocorticoids
Fraction exhaled nitric oxide
