布地奈德/福莫特罗对咳嗽变异性哮喘患者FeNO及血浆hs-CRP影响的研究  

The effect of Budesonide/formoterol on FeNO and serum hs-CRP of cough variant asthma patients

作　　者：周敏[1] 丁宇[1] 程胜[1] 王爱利[1] 谢敏[1] 谢俊刚[1] 熊维宁[1] 赵建平[1] 徐永健[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院呼吸与危重症医学科,武汉430030

出　　处：《临床内科杂志》2014年第3期164-167,共4页Journal of Clinical Internal Medicine

基　　金：国家自然科学基金青年基金资助项目（30900648）;湖北省自然科学基金面上基金资助项目（2013CFB169）

摘　　要：目的 探讨布地奈德/福莫特罗治疗对咳嗽变异性哮喘（CVA）患者呼气一氧化氮（FeNO）及血浆超敏C反应蛋白（hs-CRP）水平的影响,比较FeNO和hs-CRP两种方法在反映CVA患者气道炎症方面的价值.方法 将25例CVA患者作为实验CVA组,24例健康体检者为对照组.所有研究对象均进行肺功能和支气管激发试验.所有CVA患者接受布地奈德/福莫特罗干粉吸入治疗4周（160 μg/4.5 μg,每12小时1次）,比较治疗前后咳嗽症状总积分、FeNO和血浆hs-CRP水平变化,并进行相关性分析.结果 （1）CVA患者治疗前FeNO和hs-CRP水平明显高于正常对照组（P均＜0.01）.FeNO水平与咳嗽症状总积分明显相关（r=0.602,P＜0.01）.（2）布地奈德/福莫特罗吸入治疗4周后患者咳嗽症状总积分、FeNO和hs-CRP较治疗前均明显下降（P＜0.01或P＜0.05）.（3）治疗后咳嗽缓解患者的基线FeNO水平明显高于未缓解者,且FeNO下降的比例与咳嗽总积分下降比例明显相关（r =0.466,P＜0.05）,而hs-CRP下降比例与咳嗽总积分下降比例无明显相关.结论 布地奈德/福莫特罗吸入治疗4周可以有效改善CVA患者症状,同时降低FeNO和血浆hs-CRP水平.相比血浆hs-CRP水平,监测FeNO在评价CVA患者气道炎症及激素治疗反应方面更有优势.Objective To study the effect of the treatment with Budesonide/formoterol on the level of exhaled nitric oxide（FeNO） and serum high-sensitivity C-reactive protein（hs-CRP） of the cough variant asthma（CVA） patients. The clinical utility of FeNO and hs-CRP as a marker to monitor airway inflammation in CVA were compared. Methods Patients with CVA （ n = 25 ） and healthy subjects （ n = 24） were recruited into this study. All the subjects accepted pulmonary function tests and bronchial prova- cating test. The cough symptom scores, FeNO and serum hs-CRP in the patients with CVA were compared and correlation analyzed before and after treatment with Budesonide/formoterol（ 160 p,g/4.5 p^g ql2h） in- halation for 4 weeks. Results （ 1 ） FeNO and hs-CRP levels in the CVA patients before treatment both were significantly higher than the health group（P 〈 0.01 ）. FeNO and cough total score significantly corre- lated（ r = 0. 602, P 〈 0.01 ）. （2）After Budesonide/formoterol inhalation 4 weeks, the total cough score, FeNO and serum hs-CRP levels in the CVA patients were significantly decreased （P 〈 0.01 or P 〈 0.05）. （3） The baseline FeNO levels in patients of cough relieving after treatment was significantly higher than those wilhout relieving. And the decline proportion in FeNO of the cough relieving patients significantly correlatl.d（ r =0. 466,P 〈0.05） with the decline proportion in cough total scores. While the decline pro- portions in hs-CRP with the cough total score decreased proportion was no significant correlation. Conclu- sion The treatment of Budesonide/formoterol for 4 weeks could relieve symptoms in patients with CVA, while reducing FeNO and serum hs-CRP levels. FeNO is more useful than serum hs-CRP as a marker of airway inflammation in patients with CVA and monitoring steroid treatment response.

关 键 词：咳嗽变异性哮喘 呼出气一氧化氮 超敏C反应蛋白 

分 类 号：R725.622.5[医药卫生—儿科]