呼出气一氧化氮测定在慢性阻塞性肺疾病频繁加重表型中的作用研究  

Study on the role of exhaled NO in the frequent aggravation phenotype of chronic obstructive pulmonary disease

作　　者：王述红[1] 何正光[1] 邱容[1] 罗晓斌[1] 赵勇[1] 罗文[1] 杜发旺 李丽[1] 罗丽[1] 赵界[1] WANG Shu-hong;HE Zheng-guang;QIU Rong;LUO Xiao-bin;ZHAO Yong;LUO Wen;DU Fa-wang;LI Li;LUO Li;ZHAO Jie(Suining Central Hospital,Suining,Sichuan 629000,China)

机构地区：[1]遂宁市中心医院,四川遂宁629000

出　　处：《临床肺科杂志》2021年第12期1861-1865,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨呼出气一氧化氮(Exhaled nitric oxide,FeNO)测定在慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)频繁加重表型中的作用。方法回顾性分析2017年2月-2019年2月在本院就诊的COPD频繁加重表型56例患者(为频繁组)的临床资料,以同时期COPD非频繁加重表型56例作为对照(非频繁组),均空腹抽取静脉血,观察两组稳定期和急性期嗜酸性粒细胞数、嗜酸性粒细胞比值、C反应蛋白(CRP)、PCT、FeNO变化并比较。结果急性期频繁组嗜酸性粒细胞数、嗜酸性粒细胞比值、CRP、PCT、FeNO显著高于非频繁组,差异有统计学意义(P<0.05),而稳定期两组间上述各指标比较差异均不显著(P>0.05)。COPD频繁加重组与非频繁加重组急性期嗜酸性粒细胞数、嗜酸性粒细胞比值显著低于稳定期,而CRP、PCT、FeNO均显著高于稳定期(P<0.05)。FeNO异常者的嗜酸性粒细胞数、嗜酸性粒细胞比值均低于FeNO正常者,CRP、PCT均高于FeNO正常者,但COPD急性期及频繁组中FeNO正常者和异常者之间比较差异有统计学意义(P<0.05),而COPD稳定期及非频繁组中上述指标比较差异无统计学意义(P>0.05)。结论COPD频繁加重表型气道内FeNO浓度增高和COPD内肺组织内炎症反应明显增强有关,且FeNO浓度下降和COPD病情转归相关,可作为COPD病情变化和预后作重要参考依据。Objective To investigate the effect of exhaled nitric oxide(FeNO)in frequent exacerbator phenotype with chronic obstructive pulmonary disease(COPD).Methods A retrospective analysis was conducted on 56 patients with COPD frequent aggravation phenotype treated in our hospital from February 2017 to February 2019.Another 56 patients with COPD infrequent aggravation phenotype during the same period were taken as controls.The changes of eosinophil number,eosinophil ratio,C-reactive protein(CRP),PCT and FeNO were observed and compared.Results The number of eosinophils,the ratio of eosinophils,CRP,PCT and FeNO in the frequent group were significantly higher than those in the non-frequent group at acute stage(P<0.05),but there was no significant difference between the two groups at stable stage(P>0.05).The number of eosinophils and the ratio of eosinophils at acute phase of COPD were significantly lower than those at stable phase in the two groups(P<0.05),while CRP,PCT and FeNO in the acute phase of COPD were significantly higher(P<0.05).The number of eosinophils and the ratio of eosinophils in abnormal FeNO were significantly lower than those in normal FeNO,and CRP and PCT were significant higher than those in normal FeNO,while there was no significant difference between normal and abnormal FeNO in the stable COPD group and the non-frequent group(P>0.05).Conclusion The frequent aggravation of COPD is related to the increase of FeNO concentration in the airway and the marked increase of inflammatory reaction in the lung tissue of COPD,and the decrease of FeNO concentration is related to the prognosis of COPD,which can be used as an important reference for the change and prognosis of COPD.

关 键 词：一氧化氮 慢性阻塞性肺疾病 频繁加重表型 嗜酸性粒细胞 C反应蛋白 降钙素原 

分 类 号：R563.9[医药卫生—呼吸系统]