摘要
目的检测慢性阻塞性肺疾病(COPD)糖皮质激素治疗患者呼出气一氧化氮(FeNO)水平,并分析FeNO对糖皮质激素治疗反应的预测价值。方法选择2019年1月至2021年5月于南阳市第二人民医院呼吸科采用糖皮质激素治疗的82例COPD患者作为研究对象。所有患者均在治疗前测定FeNO水平,并采用糖皮质激素(布地奈德福特罗吸入粉雾剂)连续治疗14 d,详细统计患者的一般资料及糖皮质激素治疗反应性情况,将糖皮质激素治疗有反应性的患者纳入反应组,无反应性的患者纳入无反应组。并采用受试者工作特征曲线(ROC),以曲线下面积(AUC)检验FeNO对COPD患者糖皮质激素治疗反应性的预测价值。结果82例COPD患者经糖皮质激素连续治疗14 d,共有56例患者存在治疗反应性,占比68.29%,26例患者无治疗反应性,占比31.71%;反应组FeNO低于无反应组,第1秒用力呼气容积水平高于无反应组,差异有统计学意义(P<0.05);绘制ROC曲线图,结果显示,FeNO对COPD患者糖皮质激素治疗反应性的预测价值的AUC为0.820,预测价值较好,AUC的95%CI为0.720~0.921,标准误0.051,最佳阈值为30.975μg·L^(-1),敏感度为0.808,特异度为0.625,约登指数0.433。结论FeNO对慢性阻塞性肺疾病患者糖皮质激素治疗反应性的预测价值较好,可为临床提供一定的参考。
Objective To detect the level of fractional exhaled nitric oxide(FeNO)in patients with chronic obstructive pulmonary disease(COPD)treated with glucocorticoid,and to analyze the predictive value of FeNO on the response to glucocorticoid.Methods A total of 82 patients with COPD treated with glucocorticoid in Department of Respiratory Medicine,Nanyang Second People’s Hospital from January 2019 to may 2021 were selected as the research subjects.All patients were measured FeNO level before treatment and treated with glucocorticoid(budesonide and formoterol fumarate powder for inhalation)for 14 continuous days.The general information of patients and the reactivity of glucocorticoid treatment were counted in detail.The patients with reactivity to glucocorticoid treatment were included in the reaction group and the patients without reactivity were included in the non reaction group.The receiver operating characteristic curve(ROC)was used,and the area under the curve(AUC)was used to test the predictive value of FeNO on glucocorticoid treatment reactivity in patients with COPD.Results Eighty-two patients with COPD were treated with glucocorticoid for 14 continuous days.A total of 56 patients had treatment reactivity,accounting for 68.29%,and 26 patients did not have treatment reactivity,accounting for 31.71%.The level of FeNO in the reaction group was lower than that in the non reaction group,and the level of forced expiratory volume in one second was higher than that in the non reaction group,the difference was statistically significant(P<0.05).Drew the ROC curve,and the results showed that the AUC of predictive value of FeNO for glucocorticoid treatment reactivity in patients with COPD was 0.820,and the predictive value was good.The 95%CI of AUC was 0.720-0.921,the standard error was 0.051,the optimal threshold was 30.975μg·L^(-1),the sensitivity was 0.808,the specificity was 0.625,and the Youden index was 0.433.Conclusion FeNO has good predictive value for glucocorticoid treatment reactivity in patients with chronic
作者
郝琳
康娟
HAO Lin;KANG Juan(Department of Respiratory Medicine,Nanyang Second People’s Hospital,Nanyang 473000,China)
出处
《河南医学研究》
CAS
2022年第23期4341-4344,共4页
Henan Medical Research
基金
河南省医学科技攻关计划联合共建项目(LHGJ20191465)
南阳市科技计划项目(KJGG157)。
关键词
慢性阻塞性肺疾病
呼出气一氧化氮
糖皮质激素
反应性
预测
chronic obstructive pulmonary disease
fractional exhaled nitric oxide
glucocorticoid
reactivity
prediction
