呼出气一氧化氮检测在慢性咳嗽诊治中的价值  

The application value of detection of fractional exhaled nitric oxide in diagnosis of chronic cough

作　　者：楚辉[1] 张杰[1] CHU Hui;ZHANG Jie(Department of Respiratory Medicine,Tiantan Hospital Affiliated to Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院呼吸内科,北京市100070

出　　处：《河北医药》2022年第15期2299-2303,共5页Hebei Medical Journal

基　　金：北京市临床重点专科项目经费资助项目[编号:京卫医(2020)129号]。

摘　　要：目的探讨呼出气一氧化氮(FeNO)检测在慢性咳嗽临床诊治中的价值。方法选择呼吸内科就诊的慢性咳嗽患者158例进行FeNO检测,对结果进行分析。结果158例患者中咳嗽变异性哮喘(CVA)患者62例,平均FeNO值为(75.39±24.55)ppb;上气道咳嗽综合征(UACS)患者32例,平均FeNO值为(21.09±2.75)ppb;嗜酸粒细胞性支气管炎(EB)患者28例,平均FeNO值为(52.18±3.37)ppb;胃食道反流性咳嗽(GERC)患者19例,平均FeNO值为(10.53±1.14)ppb;变应性咳嗽(AC)患者17例,平均FeNO值为(55.47±3.02)ppb。CVA组与正常对照、UACS、EB、GERC、AC组相比,差异均有统计学意义(P<0.05)。EB组与正常对照、UACS及GERC组比较,差异有统计学意义(P<0.01),而EB组AC组比较,差异无统计学意义(P>0.05)。AC组与正常对照、UACS及GERC组比较,差异有统计学意义(P<0.01)。UACS与正常对照及GERC组比较,差异无统计学意义(P>0.05),GERC组与UACS组比较,有统计学差异(P<0.05)。UACS组与正常对照组比较,差异有统计学意义(P<0.05)。CVA组与正常对照、UACS、EB、AC、GERC组比较,差异有统计学意义(P<0.05)。EB组与正常对照、UACS及GERC组比较,差异有统计学意义(P<0.01),而EB组AC组比较,差异无统计学意义(P>0.05)。AC组与正常对照、UACS及GERC组比较,差异有统计学意义(P<0.01),UACS组与正常对照及GERC组比较,差异无统计学意义(P>0.05)。GERC组与正常对照组比较,差异无统计学意义(P>0.05)。CVA、EB、AC组分别给予吸入布地奈德治疗,3组治疗总有效率为94.39%。CVA、EB、AC 3组患者给予激素治疗4周后复测FeNO,治疗前后FeNO水平差异有统计学意义(P<0.05)。结论FeNO检测在慢性咳嗽的临床诊治中具有重要价值;FeNO可作为评估气道炎症的方法,可以把嗜酸粒细胞相关性气道炎症疾病从慢性咳嗽的其他病因中识别出来,且可作为激素治疗有效的预测指标。Objective To investigate the application value of detection of fractional exhaled nitric oxide(FeNO)in diagnosis of chronic cough.Methods A total of 158 patients with chronic cough who were treated in our hospital were enrolled in the study,and the FeNo levels were detected,and results were statistically analyzed.Results Of the 158 patients,and the average value of FeNO in 62 patients with CVA was(75.39±24.55)ppb,and that in 32 patients with UACS was(21.09±2.75)ppb,and that in 28 patients with EB was(52.18±3.37)ppb,and that in 19 patients with GERC was(10.53±1.14)ppb,and that in 17 patients with AC was(55.47±3.02)ppb.There were significant differences in the FeNO levels between CVA group and the other groups(P<0.05),so were between EB group and control group,UACS group,GERC group(P<0.05),however,there were no significant differences between EB group and AC group(P>0.05).Moreover there were significant differences in FeNO levels between AC group and control group,UACS group,GERC group(P<0.05),so were between GERC group and UACS group and between UACS and control group(P<0.05),however,there were no significant differences between EB group and AC group,nor were between UACS group and control group,GERC group(P>0.05).After the patients in CVA group,EB group,AC group were treated by budesonide,the total effective rate was 94.39%.There were significant differences in FeNO levels in CVA group,EB group,AC group before treatment and after 4-week treatment(P<0.05).Conclusion The detection of FeNO is of important value in diagnosis of chronic cough,and FeNO can be used as the method of evaluating airway inflammation,which can identify eosinophil-associated airway inflammation diseases from the other causes of chronic cough,and can be used as an index of predicting the effectiveness of corticosteroid therapy.

关 键 词：慢性咳嗽 呼出气一氧化氮 咳嗽变异性哮喘 嗜酸粒细胞性支气管炎 变应性咳嗽 

分 类 号：R441.5[医药卫生—诊断学]