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作 者:许重英 钟明媚 李秀 XU Zhongying;ZHONG Mingmei;LI Xiu(Department of Respiratory and Critical Care Medicine,Third Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230000,China)
机构地区:[1]安徽医科大学第三附属医院呼吸与危重症医学科,安徽合肥230000
出 处:《检验医学与临床》2021年第9期1274-1277,共4页Laboratory Medicine and Clinic
摘 要:目的探讨初始治疗前低呼出气一氧化氮(FeNO)哮喘患者中,肺泡气一氧化氮(CaNO)水平升高能否作为吸入糖皮质激素/长效β2受体激动剂(ICS+LABA)治疗获益的预测因子。方法收集该院呼吸与危重症医学科就诊的具有哮喘临床特征、舒张试验阳性且FeNO≤50 ppb的患者60例作为研究对象,依据CaNO水平是否升高分为CaNO升高组(>5 ppb)34例及CaNO正常组(≤5 ppb)26例,两组均给予布地奈德福莫特罗粉雾剂吸入治疗至少4周,治疗前后收集患者哮喘症状控制评估(ACT)评分、FeNO、CaNO及肺功能检查结果。结果两组患者治疗后肺功能均有不同程度改善,CaNO升高组治疗后ACT评分、呼气峰流量(PEF)、剩余25%肺活量时的瞬间流量(MEF25)及用力呼出25%~75%肺活量之间的平均流量(MEF75-25)较CaNO正常组改善更加明显,差异有统计学意义(P<0.05)。相关性分析提示,CaNO水平与小气道指标MEF25、MEF75-25无相关性(r=-0.10、-0.04,P>0.05),但与MEF25、MEF75-25治疗前后的改变量呈正相关(r=0.29、0.38,P<0.05)。结论CaNO可以作为远端气道炎症指标,CaNO水平升高提示患者更能从ICS+LABA治疗中获益。Objective To investigate whether the increase of alveolar nitric oxide(CaNO)level in the asthmatic patients with low exhaled nitric oxide(FeNO)before initial treatment can serve as a predictive factor of obtaining benefit in the inhaled corticosteroids/long-actingβ2 receptor agonist(ICS+LABA)therapy.Methods Sixty patients with clinical characteristics of asthma,bronchial dilation test positive and FeNO≤50 ppb in the department of respiratory and critical care medicine of this hospital were collected as the study subjects.According to whether CaNO increasing,the patients were divided into the CaNO increase group(>5 ppb,34 cases)and CaNO normal group(≤5 ppb,26 cases).Both groups were treated with budesonide/formotero powder aerosol for at least 4 weeks.The asthma symptom control assessment(ACT),FeNO,CaNO and pulmonary function examination results were collected before and after treatment.Results The pulmonary function of the two groups was improved to different degrees after treatment,and the improvement of ACT score,PEF,MEF25 and MEF75-25 in the CaNO increase group was more significant compared with those in the CaNO normal group,and the differences were statistically significant(P<0.05).The correlation analysis suggested that the CaNO level had no correlation with the small airway indicators MEF25 and MEF75-25(r=-0.10,-0.04,P>0.05),but had the positive correlation with the change amounts of MEF25 and MEF75-25 before and after treatment(r=0.29,0.38,P<0.05).Conclusion CaNO can serve as an indicator of distal airway inflammation,and the increase of CaNO level suggests that the patients can obtain more benefit from ICS+LABA treatment.
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