应用ICS治疗的稳定期慢性阻塞性肺疾病患者FeNO与EOS%测定疗效预测分析  

Predictive analysis of FeNO and EOS%in patients with stable chronic obstructive pulmonary disease treated with ICS

作　　者：刘莹[1] 杨燕[1] 刘继东[1] LIU Ying;YANG Yan;LIU Ji-dong(Department of Respiratory and Critical Care Medicine,Panzhihua Central Hospital,Panzhihua Sichuan 617000,China)

机构地区：[1]攀枝花市中心医院呼吸与危重症医学科,四川攀枝花617000

出　　处：《临床和实验医学杂志》2021年第7期715-718,共4页Journal of Clinical and Experimental Medicine

基　　金：四川省卫生厅科研课题立项(编号:120283)。

摘　　要：目的分析应用吸入糖皮质激素(ICS)治疗的稳定期慢性阻塞性肺疾病(COPD)患者呼出气一氧化氮(FeNO)与外周血嗜酸性粒细胞百分比(EOS%)测定疗效预测价值。方法前瞻性选取2017年6月至2020年1月到攀枝花市中心医院呼吸内科门诊就诊的稳定期COPD患者120例,分别行支气管舒张试验、肺功能检查、FeNO和EOS%测定。予以患者ICS治疗4周复查以上指标,根据肺功能改善情况分为ICS有效组36例与ICS无效组74例。采用pearson相关分析与受试者工作特征(ROC)曲线分析FeNO和EOS%测定ICS疗效的预测价值。结果治疗后4周,COPD患者FeNO、EOS%均较治疗前明显下降,第一秒用力呼吸量(FEV1)、用力肺活量(FVC)及最大呼气流速(PEF)均有明显提高,差异有统计学意义(P<0.05)。治疗前FeNO、EOS%与ICS治疗后ΔFVC、ΔPEF均无相关性(P>0.05),而与治疗后的ΔFEV1均呈正相关性(P<0.05)。ICS有效组治疗前与治疗后的FeNO均高于无效组,差异有统计学意义(P<0.05);ICS有效组治疗前与治疗后的EOS%与无效组对比,差异无统计学意义(P>0.05)。治疗前FENO与EOS%评估ICS疗效的曲线下面积分别为0.658、0.547,阈值分别为30 ppb、3.14%,灵敏度分别为64.9%、57.8%,特异度分别为90.8%、58.1%。结论FeNO和EOS%与ICS治疗后FEV1改善量均呈正相关,但相比之下,FeNO预测ICS治疗效果的临床价值更高。Objective To analyze the predictive value of exhaled nitric oxide(FeNO)and peripheral blood eosinophil percentage(EOS%)in patients with stable chronic obstructive pulmonary disease(COPD)treated with inhaled corticosteroids(ICS).Methods One hundred and twenty cases of patients with stable COPD who visited the outpatient department of respiratory Medicine of Panzhihua Central Hospital from June 2017 to January 2020 were selected,bronchodilation test,lung function test,FeNO and EOS%were measured respectively.The above indicators were reviewed after 4 weeks of TREATMENT with ICS,and the patients were divided into the 36 cases of ICS effective group and 74 cases of ICS invalid group according to the improvement of lung function,the above indicators were reviewed 4 weeks after ICS treatment,and the patients were divided into ICS treatment group and ineffective group according to the improvement of lung function.Pearson correlation analysis and ROC curve analysis were used to analyze FeNO and EOS%to determine the predictive value of ICS efficacy.Results FeNO and EOS%were significantly decreased after ICS treatment compared with before treatment,and forced breathing volume(FEV1),forced vital capacity(FVC)and maximum expiratory flow rate(PEF)were significantly increased after ICS treatment(P<0.05).Before FeNO,EOS%and ICS after treatmentΔFVC,ΔPEF were no correlation(P>0.05),and the treatment withΔFEV1 after all there was a positive correlation(P<0.05).FeNO before and after treatment in the ICS effective group was significantly higher than that in the non-ics effective group(P<0.05).There was no significant difference in the EOS%of ICS group before and after treatment compared with that of ICS group without treatment(P>0.05).The area under the curve of FENO and EOS%before treatment to evaluate the efficacy of ICS were 0.658 and 0.547,the thresholds were 30 ppB and 3.14%,the sensitivity was 64.9%and 57.8%,and the specificity was 90.8%and 58.1%,respectively.Conclusion FeNO and EOS%were positively correlated with the amount

关 键 词：慢性阻塞性肺疾病 吸入性糖皮质激素 外周血嗜酸细胞百分比 呼出气一氧化氮 

分 类 号：R563.9[医药卫生—呼吸系统]