呼出气一氧化氮联合诱导痰细胞学分类计数在慢性阻塞性肺疾病急性加重期中的临床意义  

The Clinical Significance of Exhaled Nitric Oxide Combined with Induced Sputum Cytological Classification Count in the Acute Exacerbation of Chronic Obstructive Pulmonary Disease

作　　者：张晶晶 赵丽丽 万亚楠 宋振鑫 张伟 ZHAGN Jing-jing;ZHAO Li-li;WAN Ya-nan;SONG Zhen-xin;ZHANG Wei(Mudanjiang Medical University,Mudanjiang Heilongjiang 157011;Department of Respiratory and Medicine,Hongqi Hospital,Affiliated Mudanjiang Medical University Mudanjiang Heilongjiang 157011;Department of General and Medicine,Hongqi Hospital,Affiliated Mudanjiang Medical University,Mudanjiang Heilongjiang 157011)

机构地区：[1]牡丹江医学院,黑龙江牡丹江157011 [2]牡丹江医学院附属红旗医院呼吸与危重症医学科,黑龙江牡丹江157011 [3]牡丹江医学院附属红旗医院全科医学,黑龙江牡丹江157011

出　　处：《世界最新医学信息文摘》2021年第26期31-33,37,共4页World Latest Medicine Information Electronic Version

基　　金：牡丹江医学院研究生创新科研项目(2019YJSC-31MY);黑龙江省卫生健康委科研课题(2019-405);黑龙江省高等学校基本科研业务费项目(2019-KYYWFMY-0044);红旗科研基金科研项目(2018-HQ-26)。

摘　　要：目的分析并探究呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)水平与诱导痰细胞学分类计数在慢性阻塞性肺疾病(chronic obstructive pulmonary disease)治疗方法中的指导意义.方法收集牡丹江医学院附属红旗医院呼吸与危重症医学科2019年10月至2020年12月期间收治入院被诊断为AECOPD的患者38例,健康对照组19例,详细记录两组的一般资料,并对AECOPD组行诱导痰细胞学分类计数、FeNO、肺功能、血常规检查,对19例健康对照组行诱导痰细胞分类计数、FeNO检查.结果(1)AECOPD组与对照组相比诱导痰中性粒细胞计数比值、巨噬细胞计数比值、嗜酸性粒细胞计数比值、淋巴细胞比值及FeNO有显著统计学意义;(2)AECOPD组诱导痰细胞学分类计数以单纯中性粒细为主型为主共有23例占61%;嗜酸性粒细胞为主型共2例占5%;混合型12例占32%;(3)AECOPD组呼出气一氧化氮与诱导痰嗜酸性粒细胞比值、外周血嗜酸性粒细胞计数具有正相关性(r值分别为0.579、0.412,P<0.05);(4)诱导痰中性粒细胞计数与FEV1/FVC、FEV1%pre皆呈负相关(r=-0.342,P<0.05;r=-0.517,P<0.05).结论与健康人相比,AECOPD患者呼出气一氧化氮水平显著增加,一定程度上有助于判断患者病情变化,且AECOPD患者诱导痰中性粒细胞比值与肺功能具有负相关性,可加速肺功能恶化,诱导痰嗜酸性粒细胞比值与血嗜酸性粒细胞计数、呼出气一氧化氮具有正相关性,可协助医师准确识别对糖皮质激素治疗敏感的患者从而指导糖皮质激素药物的应用.Objective To analyze and explore the guiding significance of exhaled nitric oxide(fractional exhaled nitric oxide,FeNO)levels and induced sputum cytological classification counts in the treatment of chronic obstructive pulmonary disease.Methods Collected 38 patients diagnosed with AECOPD and 19 healthy controls from the Department of Respiratory and Critical Care Medicine,Hongqi Hospital,Mudanjiang Medical College from December 2019 to December 2020.The general information of the two groups was recorded in detail.In the AECOPD group,differentiated counts of induced sputum cells,FeNO,lung function,and routine blood tests were performed,and 19 healthy controls were given differentiated counts of induced sputum cells and FeNO tests.Results(1)Compared with the control group,the AECOPD group had significant statistical significance in induced sputum neutrophil count ratio,macrophage count ratio,eosinophil count ratio,Lymphocyte ratio and FeNO;(2)In the AECOPD group,the classification and count of induced sputum cells were mainly pure neutrophils,accounting for 61%in 23 cases;eosinophils in 2 cases accounting for 5%;mixed in 12 cases accounting for 32%;(3)In the AECOPD group,the ratio of exhaled nitric oxide to induced sputum eosinophils and peripheral blood eosinophil count were positively correlated(r=0.579、0.412,P<0.05);(4)Induced sputum neutrophils The cell count was negatively correlated with FEV1/FVC and FEV1%pre(r=-0.342,P<0.05;-0.517,P<0.05),which adversely affected the lung function of patients.Conclusion Compared with healthy people,the level of nitric oxide in exhaled breath of AECOPD patients is significantly increased,which helps to determine the patient’s disease to a certain extent,and the ratio of induced sputum neutrophils in AECOPD patients is negatively correlated with lung function,which can accelerate the deterioration of lung function.Induced sputum eosinophil ratio and blood eosinophil count.Exhaled breath nitric oxide has a positive correlation,which can help physicians prepare to identify p

关 键 词：呼出气一氧化氮 诱导痰细胞学分类计数 慢性阻塞性肺疾病急性加重 血嗜酸性粒细胞计数 

分 类 号：R619[医药卫生—外科学]