摘要
目的探讨中央和外周气道呼出气一氧化氮(FeNO_(200))在慢性阻塞性肺病(COPD)频繁急性加重表型患者中的临床意义。方法收集2019年1月至2021年6月安徽医科大学第四附属医院呼吸与危重症医学科收治的90例COPD患者作为研究对象,在一年内因急性加重次数≥2次的患者纳入频繁急性加重组(n=23),急性加重次数≤1次的患者纳入非频繁急性加重组(n=67)。测定两组中央气道一氧化氮(FeNO_(200))浓度和外周气道呼出气一氧化氮(FeNO_(200))浓度、肺泡气一氧化氮(CaNO)浓度并收集白细胞计数、血嗜酸粒细胞百分比、血清总免疫球蛋白E(IgE)、慢性阻塞性肺疾病评估测试(CAT)评分及肺功能等相关指标,对进行对比分析。结果COPD频繁急性加重组FeNO_(200)、CaNO、C反应蛋白(CRP)、血清总IgE、CAT评分均高于非频繁急性加重组,第一秒用力呼气容积占预计值百分比(FEV1%)低于非频繁急性加重组(P<0.05)。在COPD急性加重患者中,FeNO_(200)、CaNO与FEV1%呈负相关(r=-0.305、-0.439,P<0.05),与血清总IgE呈正相关(r=0.523、0.514,P<0.05),其中CaNO还与CRP呈正相关(r=0.321,P=0.023)。结论COPD频繁急性加重表型患者中央和外周FeNO_(200)浓度存在差异,FeNO_(200)、CaNO均可作为COPD患者外周小气道炎症指标。
Objective To investigate the clinical value of central and peripheral exhaled nitric oxide detection in patients with COPD with frequent acute exacerbations.Methods A total of 90 COPD patients admitted to the Department of Respiratory and Critical Care Medicine of the Fourth Affiliated Hospital of Anhui Medical University from January 2019 to June 2021 were selected as the study subjects.We enrolled the patients of frequent exacerbations as two or more exacerbations in a year in frequent exacerbations group(n=23),and enrolled the patients of infrequent exacerbations as less than two exacerbations in a year in infrequent exacerbations group(n=67).The concentration of central airway nitric oxide(FeNO_(200)),peripheral airway exhaled nitric oxide(FeNO_(200)) and alveolar nitric oxide(CaNO)were measured in the two groups.White blood cell(WBC)count,blood eosinophil percentage(EOS%),serum total IgE,Chronic Obstructive Pulmonary Disease Assessment Test(CAT)score,lung function and other related indicators were collected.The above indexes were compared and analyzed.Results COPD frequent acute recombination and FeNO_(200),CaNO,CRP,serum total IgE,CAT score were significantly higher than infrequent acute recombination.The percentage of forced expiratory volume in the first second to the expected value(FEV1%)was significantly lower than infrequent acute recombination(P<0.05).FeNO_(200) and CaNO were negatively correlated with FEV1%in patients with acute exacerbation of COPD(r=-0.305,-0.439,P<0.05),was positively correlated with serum total IgE(r=0.523,0.514,P<0.05),and CaNO was positively correlated with CRP(r=0.321,P=0.023).Conclusions There are differences in central and peripheral exhated nitric oxide between patients with COPD frequent acute exacerbation phenotype.FeNO_(200) and CaNO can both be used as indicators of peripheral small airway inflammation.
作者
林明珍
金蒙蒙
曹晓慧
LIN Mingzhen;JIN Mengmeng;CAO Xiaohui(Department of Respiratory and Critical Care Medicine,the Fourth Affiliated Hospital of Anhui Medical University,Hefei 230061,China)
出处
《安徽医学》
2022年第12期1397-1402,共6页
Anhui Medical Journal
基金
安徽省高校自然科学基金项目(项目编号:2019xky061)。
关键词
一氧化氮
慢性阻塞性肺病
频繁急性加重表型
外周气道呼出气一氧化氮
肺泡气一氧化氮
Nitric oxide
Chronic obstructive pulmonary disease
Frequent acute exacerbation phenotype
The peripheral airway exhales nitric oxide
Alveolar nitric oxide
