呼出气一氧化氮浓度在基层医院门诊咳嗽中诊断及指导价值  

Diagnosis and guidance value of FeNO in the cough of outpatients in basic hospitals

作　　者：封国红 陈志祥 万妮惠子 Feng Guohong;Chen Zhixiang;Wanni Huizi(Department of Respiratory,Wuhu Hospital of Traditional Chinese Medicine.Anhui 241000,China)

机构地区：[1]安徽省芜湖市中医院呼吸与危重症科,241000

出　　处：《山西医药杂志》2020年第20期2757-2760,共4页Shanxi Medical Journal

摘　　要：目的探讨呼出气一氧化氮(FeNO)指导门诊经验性使用激素及孟鲁斯特治疗亚急性、慢性咳嗽的作用。方法根据FeNO值分为≤32×10^(-9)mol/L组及>32×10-9mol/L组,每组各分为使用吸入激素ICS、孟鲁斯特及未使用两药,根据咳嗽症状总积分比较治疗前后缓解率,并进行相关性分析。结果①高FeNO组与低FeNO组在性别、年龄、吸烟状况、病程、上呼吸道感染史、鼻炎病史、伴随胸闷、伴咽部不适、咳嗽日间症状积分等方面差异均无统计学意义。而高FeNO组中既往有类似咳嗽病史、夜间咳嗽及夜间咳嗽症状积分明显高于低FeNO组。②血嗜酸性粒细胞比例与FeNO值存在显著正相关(r=0.5,P<0.01)。②高FeNO组中未用两药组日间、夜间有效率分别45.5%、66.7%,使用两药组日间、夜间有效率分别95.8%、94.5%,差异有统计学意义(P<0.01)。结论FeNO值结合夜间咳嗽、既往类似病史可指导亚急性、慢性咳嗽使用ICS及孟鲁斯特钠经验性治疗。Objective To explore the efficacy of applicating the FeNO values to guide the empirical outpatient using of corticosteroids and Montelukast in the treatment of subacute and chronic cough.Methods The patients were divided into two groups according to the FeNO values:≤32×10-9 mol/L and>32×10-9 mol/L.Each group was further divided into those with ICS and Montelukast treatment and those without.The total scores of cough symptoms before and after treatment were compared,and the correlation analysis was carried out.Results①There was no significant statistical difference between the high FeNO group and the low FeNO group in terms of gender,age,smoking,course of disease,history of upper respiratory tract infection,history of rhinitis,concomitant chest tightness,pharyngeal discomfort,and cough daytime symptom scores.However,the scores of history of cough,night cough,and night cough symptom in the high FeNO group were significantly higher than those in the low FeNO group.②There was a significant positive correlation between the proportion of blood eosinophils and the values of FeNO(r=0.5,P<0.01).③In the high FeNO group,the effective rates of the group without ICS and Montelukast treatment were 45.5%and 66.7%during the day and night,respectively.And the group with ICS and Montelukast treatment has the effective rates of 95.8%and 94.5%during the day and night,respectively.The difference was statistically significant(P<0.01).Conclusion The FeNO values combined with the scores of night cough and similar medical history can be applicated to guide empirical treatment with ICS and Montelukast for subacute cough.

关 键 词：咳嗽 呼出气一氧化氮 ICS 孟鲁斯特钠 

分 类 号：R56[医药卫生—呼吸系统]