老年慢性阻塞性肺疾病急性加重期患者呼出气NO的临床意义  

Clinical value of fractional exhaled nitric oxide in guiding the treatment of acute exacerbation of chronic obstructive pulmonary disease in the elderly

作　　者：刘靖[1] 孙洪[1] 雷映红[1] 李秀娟[1] LIU Jing;SUN Hong;LEI Ying-hong;LI Xiu-juan(Wuhan No.1 Hospital,Wuhan 430022,China)

机构地区：[1]武汉市第一医院

出　　处：《内科急危重症杂志》2019年第5期367-369,377,共4页Journal of Critical Care In Internal Medicine

基　　金：武汉市第一医院院内资助科研项目(No:2017Y16)

摘　　要：目的:探讨测定呼出气一氧化氮(FeNO)对老年慢性阻塞性肺疾病急性加重期(AECOPD)患者炎症水平的评估作用和临床价值。方法:选取老年AECOPD患者100例,根据FeNO测量值,分为FeNO<27 ppb组50例,FeNO≥27 ppb组50例,2组患者又分为激素治疗组及非激素治疗组各25例,分别检测2组患者治疗前、后的FeNO值并评价疗效。结果:FeNO≥27 ppb组中,激素治疗组的疗效明显好于非激素治疗组;激素治疗组治疗后FeNO测量值明显下降。FeNO<27 ppb组中,激素治疗组与非激素治疗组比较,疗效差异无统计学意义。非激素治疗的所有患者中,FeNO<27 ppb组中显效、有效总例数高于FeNO≥27 ppb组,FeNO测量值治疗前后比较,差异无统计学意义。结论:FeNO检测可作为AECOPD患者临床辅助检查工具,有助于反映患者的气道炎症水平,预测患者对激素的反应性,对指导老年患者的用药有一定的意义。Objective: To investigate the effect and clinical value of fractional exhaled nitric oxide(FeNO) in guiding the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) in the elderly. Methods: The 100 elderly patients with AECOPD were selected. Based on the detection results in FeNO, there were 50 patients with the FeNO < 27 ppb, and 50 patients with the FeNO ≥ 27 ppb. The 2 groups were further divided into hormone treatment sub-group and non-hormone treatment sub-group randomly, with 25 patients per group. FeNO was measured and symptom was assessed before and after treatment in the 2 groups, respectively, so as to evaluate the efficacy. Results: In the FeNO≥27 ppb group, excellent rate and effective rate in the hormone treatment sub-group were significantly higher than those in the non-hormone treatment sub-group. The FeNO value increased significantly after treatment as compared with that before treatment. In the FeNO < 27 ppb group, no statistically significant differences were found in excellent rate or effective rate between the hormone treatment sub-group and the non-hormone treatment sub-group. In both non-hormone treatment sub-groups, excellent rate and total effective rate in the FeNO < 27 ppb group were higher than in the FeNO ≥ 27 ppb group, and no statistically significant differences were detected in the FeNO value before and after treatment. Conclusion: FeNO measurement can be used as a clinical auxiliary examination tool in the diagnosis and treatment of COPD. It has certain significance in reflecting the degree of airway inflammation in patients with AECOPD, predicting the response of patients with COPD to glucocorticoids and guiding the medication of elderly patients.

关 键 词：慢性阻塞性肺疾病急性加重期 呼出气NO 糖皮质激素 

分 类 号：R563[医药卫生—呼吸系统]