哮喘-慢阻肺重叠综合征患者呼出气一氧化氮与诱导痰嗜酸粒细胞及肺功能的相关性研究  

The Correlation between Exhaled Nitricoxide and Eosinophils in Induced Sputum and Pulmonary Function in Patients with Asthma-COPD Overlap Syndrome

作　　者：刘凌云[1] 

机构地区：[1]广东省江门市中心医院呼吸内科,529000

出　　处：《岭南急诊医学杂志》2016年第3期226-227,232,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨哮喘-慢性阻塞性肺疾病重叠综合征(ACOS)患者呼出气一氧化氮(NO)与诱导痰嗜酸粒细胞(EOS)及肺功能的相关性及其与吸入糖皮质激素(ICS)治疗效果的关系,为ACOS的诊断及治疗提供依据。方法:以2012年6月-2014年6月我院诊治的稳定期ACOS患者为ACOS组(n=60),以同期诊治的无合并哮喘的稳定期慢性阻塞性肺疾病(COPD)患者单纯COPD组(n=60)。受试者均接受单纯ICS治疗3个月,治疗前后行肺通气功能检查、支气管舒张试验、呼出气NO检测及诱导痰中炎性细胞的分析。结果:ACOS组呼出气NO及诱导痰EOS计数均显著高于单纯COPD组,且呼出气NO与诱导痰EOS计数显著正相关、与FEV1显著负相关。ROC曲线分析显示以30ppb为截点呼出气NO诊断ACOS的敏感度为86.1%,特异度为85.7%。ICS治疗后的FEV1值增幅ACOS组亦显著高于单纯COPD组。ACOS组ICS治疗后的FEV1值增幅与呼出气NO检测显著正相关。结论:呼出气NO与ACOS患者气道EOS炎症及肺功能下降相关,且能较好地预测ACOS对ICS治疗的反应性。Objective ：To study the correlation between exhaled nitric oxide（NO） and induced sputum eosinophil cell（EOS） and pulmonary function in asthma and chronic obstructive pulmonary disease（COPD） overlap syndrome（ACOS） patients. and the treatment effect of inhaled glucocorticoid（ICS）, so as to provide basis for the diagnosis and treatment of ACOS. Methods ：60 patients with ACOS were classified as ACOS group from Jun 2012 to Jun 2014,while the 60 patients with COPD and non asthma were classified as pure COPD group in the same period. All subjects underwent pulmonary function tests, including bronchial dilation test, analysis of exhaled NO and inflammatory cells in induced sputum. Results ： Exhaled NO detection and induced sputum EOS counts were significantly higher in ACOS groups than those in pure COPD group and exhaled NO and induced sputum EOS count was positively correlated, which was negative correlated with FEV1. ROC curve analysis showed that using 30 ppb as the cut-off point of exhaled NO in the diagnosis of ACOS sensitivity was 86.1%,specificity was 85.7%. After treatment of ICS,FEV increase in the ACOS group was significantly higher than that of the pure COPD group. And FEV increase was positively correlated with the level of exhaled NO. Conclusions ：Exhaled NO was related to the airway EOS inflammation and decline of lung function in ACOS,and could predict the ICS therapy response in ACOS.

关 键 词：慢性阻塞性肺疾病 哮喘 吸入糖皮质激素 肺功能 呼出气一氧化氮 

分 类 号：R562.25[医药卫生—呼吸系统]