过敏性哮喘患者上下气道呼出气一氧化氮水平及与肺功能指标的相关性  

Level of fractional exhaled nitric oxide in the upper and lower airways and its correlation study with lung function of allergic asthma

作　　者：郑丽颖 刘运秋 耿贺梅 汪静[3] 王静[4] 宋路 王丽晔 纪春梅[3] 兰璇 杨晓燕 Liying Zheng;Yunqiu Liu;Hemei Geng;Jing Wang;Jing Wang;Lu Song;Liye Wang;Chunmei Ji;Xuan Lan;Xiaoyan Yang(Department of Respiratory and Critical Care Medicine,Affiliated Kailuan Hospital,North China University of Science and Technology,Tangshan 063000,China;Department of Infection Control,Affiliated Kailuan Hospital,North China University of Science and Technology,Tangshan 063000,China;Department of Respiratory Medicine,Tangshan Union Medical College Hospital,Tangshan 063000,China;Department of Internal Medicine of Fangezhuang Hospital,Affiliated Kailuan Hospital,Tangshan 063199,China)

机构地区：[1]华北理工大学附属开滦总医院呼吸与危重症医学科,唐山063000 [2]华北理工大学附属开滦总医院感染管理科,唐山063000 [3]唐山市协和医院呼吸科,063000 [4]开滦总医院范各庄医院内科,唐山063199

出　　处：《国际呼吸杂志》2021年第22期1720-1725,共6页International Journal of Respiration

基　　金：国家重点研发计划专项课题(2016YFC1303900);2017年省卫计委医学科学研究课题计划项目(20171446)。

摘　　要：目的检测过敏性支气管哮喘(哮喘)呼出气一氧化氮(FeNO)及鼻呼出气一氧化氮(FnNO)的水平及其与肺功能指标的相关性。方法回顾性研究。以2018年2月至2019年5月开滦总医院就诊行FeNO、FnNO检测者作为研究对象, 其中成人哮喘82例(哮喘组), 非哮喘组43例(对照组)。根据2019年中国过敏性哮喘诊治指南将哮喘组分为过敏性哮喘组和非过敏性哮喘组, 每组41例。分析3组FeNO、FnNO水平及其与哮喘组肺功能指标的相关性。结果 3组中FeNO、FnNO值过敏性哮喘组最高, 非过敏性哮喘组其次, 对照组最低, 3组比较差异均有统计学意义(P值均<0.001), 3组间两两比较差异均有统计学意义(P值均<0.05)。过敏性哮喘组FeNO值与基础肺功能指标用力肺活量占预计值的百分比(FVC%pred)、第1秒用力呼气量占预计值的百分比(FEV1%pred)、FEV1/FVC、呼气峰流速占预计值的百分比(PEF%pred)、用力呼出25%肺活量的呼气流速占预计值的百分比(FEF25%pred)、FEF50%pred、FEF75%pred、最大呼气中段流量占预计值的百分比均呈负相关(r=-0.454、-0.560、-0.322、-0.519、-0.483、-0.503、-0.442、-0.501, P值均<0.05)。非过敏性哮喘组FeNO值与FEV1、FEV1%pred均呈正相关(r=0.346、0.359, P值均<0.05)。结论 FeNO、FnNO水平在过敏性哮喘患者中明显增高, 过敏性哮喘患者FeNO水平与大小气道肺功能呈负相关, 是反映该类患者气道功能的一个良好指标。Objective To measure the level of fractional exhaled nitric oxide(FeNO)and nasal fractional exhaled oxide(FnNO)and its correlation study with lung function of allergic bronchial asthma(asthma).Methods This was a retrospective study.FeNO and FnNO patients in Kailuan General Hospital from February 2018 to May 2019 were selected as the study subjects,including 82 cases of adult asthma(asthma group)and 43 cases of non-asthma group(control group).According to the 2019 Chinese Guidelines for diagnosis and treatment of allergic asthma,the asthma group was divided into allergic asthma group and non-allergic asthma group,with 41 cases in each group.The levels of FeNO and FnNO and their correlations with lung function indexes in asthma group were analyzed.Results The values of FeNO and FnNO in allergic asthma group were the highest,followed by non-allergic asthma group and the lowest in control group.The differences among the three groups were statistically significant(all P<0.05).Pairwise comparison between the three groups showed statistically significant differences(all P<0.05).In allergic asthma group,FeNO value and the basic lung function indexes of forced expiratory vital capacity as a percentage of expected value(FVC%pred),forced expiratory volume in the first second as a percentage of expected value(FEV1%pred),FEV1/FVC,the peak expiratory flow as a percentage of expected value(PEF%pred),the forced expiratory flow after 25%of the FVC has been exhaled as a percentage of expected value(FEF25%pred),the FEF50%pred,the FEF75%pred,and the percentage of maximum mid-expiratory flow in predicted value were all negatively correlated(r=-0.454,-0.560,-0.322,-0.519,-0.483,-0.503,-0.442,-0.501,all P<0.05).FeNO was positively correlated with FEV1 and FEV1%pred in non-allergic asthma group(r=0.346,0.359,both P<0.05).Conclusions FeNO and FnNO levels are significantly increased in allergic asthma patients,and FeNO levels are negatively correlated with the lung function of large and small airways,which is a good indicator of airway fu

关 键 词：哮喘 一氧化氮 肺功能试验 

分 类 号：R562.25[医药卫生—呼吸系统]