呼出气一氧化氮测定对妊娠期支气管哮喘患者的诊断意义  

Significance of fractional exhaled nitric oxide in the diagnosis of asthma in pregnant women

作　　者：吴立琴[1] 黎志雄[1] 戴元荣[1] 李凤琴[1] 

机构地区：[1]温州医科大学附属第二医院呼吸内科,浙江325027

出　　处：《中华结核和呼吸杂志》2015年第2期115-118,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：温州市科技局科研基金（Y20120009）

摘　　要：目的 观察妊娠支气管哮喘（哮喘）患者呼出气一氧化氮（FeNO）的变化,探讨其对妊娠期哮喘患者的诊断意义.方法 采用前瞻性研究,选择2012年10月至2014年4月就诊于温州医科大学附属第二医院的健康妊娠女性65例、哮喘非妊娠患者55例、哮喘妊娠患者40例,以及来自体检中心的健康非妊娠女性60名,检测各组FeNO水平;对比15名健康妊娠组不同妊娠周期FeNO水平;分析哮喘妊娠组FeNO水平与FEV1占预计值％、哮喘控制测试（ACT）评分及血嗜酸粒细胞百分比间的相关关系.结果 健康妊娠组FeNO水平为（12 ±6）ppb,与健康非妊娠组（14 ±5） ppb相比,差异无统计学意义（=0.508,P＞0.05）;不同妊娠周期孕妇FeNO水平差异无统计学意义（F=0.656,P＞0.05）;哮喘妊娠组FeNO值为（43 ±21）ppb,高于健康妊娠组（t=2.981,P＜0.05）;哮喘妊娠组FeNO水平与哮喘非妊娠组（51±32） ppb相比,差异无统计学意义（t=0.366,P＞0.05）.相关分析显示哮喘妊娠组FeNO水平与FEV1占预计值％（r=0.164,P＞0.05）、ACT评分（r=0.272,P＞0.05）均无明显相关性,与血嗜酸粒细胞百分比呈正相关（r=0.723,P＜0.05）.结论 妊娠及不同妊娠周期对FeNO水平无明显影响,哮喘妊娠期患者FeNO水平明显升高,FeNO水平反映嗜酸粒细胞炎症程度,可协助诊断妊娠期哮喘.Objective To assess the variability of fractional exhaled nitric oxide（FeNO） and to explore the significances of FeNO in the diagnosis and treatment of asthma in pregnant women.Methods In a prospective study,65 healthy pregnant women,55 asthmatic non-pregnant women,40 asthmatic pregnant women and 60 healthy non-pregnant women were enrolled in the study from Oct 2012 to Apr 2014.FeNO levels of the 4 groups were compared,and the variability of FeNO in different pregnancy periods of 15 heahhv pregnant women were examined.We also analyzed the correlation between the level of FeNO,FEV1% pred,asthma control test （ACT） scores andblood eosinophils in patients of asthmatic pregnant women.Results The difference in the levels of FeNO between heahhy pregnant women （12 ± 6） ppb and healthy non-pregnant women （14 ± 5） ppb were no significant （t =0.508,P 〉 0.05）.The levels of FeNO in different pregnancy periods of healthy pregnant women were not significantly different （F =0.656,P 〉 0.05）.Compared with healthy pregnant women（12 ± 6）ppb,the level of FeNO was significantly higher in asthmatic pregnant patients（43 ± 21） ppb （t =2.981,P 〈 0.05）,but the difference of the levels of FeNO between asthmatic non-pregnant（51 ± 32）ppb and pregnant patients （43 ± 21） ppb were no significant （t =0.366,P 〉0.05）.There was no significant correlation between FeNO level and FEV1 % pred （r =0.164,P 〉 0.05）,nor between FeNO level and ACT scores （r =0.272,P 〉 0.05）,but there was significant correlation between FeNO level and eosinophils （r =0.723,P 〈 0.05）.Conclusions FeNO level is not influenced by pregnancy and different gestation periods.FeNO level in asthmatic pregnant women is increased,and FeNO is an important examination in the diagnosis of asthma during pregnancy.

关 键 词：妊娠 哮喘 一氧化氮 

分 类 号：R562.25[医药卫生—呼吸系统]