稳定期COPD患者呼出气一氧化氮与不同血嗜酸性粒细胞水平的相关性分析  

Correlation analysis of exhaled breath nitric oxide with different blood eosinophil levels in patients with stable COPD

作　　者：汪伯宇 丁洁珠 徐平 WANG Boyu;DING Jiezhu;XU Ping(Zhuhai Campus,Zunyi Medical University,Zhuhai 519000,Guangdong,China;Peking University Shenzhen Hospital,Shenzhen 518000,Guangdong,China)

机构地区：[1]遵义医科大学珠海校区,广东珠海519000 [2]北京大学深圳医院,广东深圳518000

出　　处：《西部医学》2023年第7期1024-1029,共6页Medical Journal of West China

基　　金：广东省自然科学基金资助项目(2023A1515012460);深圳市科创委资助项目(JCYJ20210324105411031);深圳市高水平医院建设专项经费资助项目(LCYJ2021022,LCYJ2021008)。

摘　　要：目的 探讨稳定期慢性阻塞性肺疾病(COPD)患者呼出气一氧化氮(FeNO)与不同血嗜酸性粒细胞(EOS)水平之间的相关性及其临床应用价值。方法 回顾性分析2020年1月—2022年11月北京大学深圳医院收治的187例稳定期COPD患者,以EOS百分比分界值为2%分为A、B两组(A组EOS%<2%,B组EOS%≥2%),分别收集两组患者的基本信息[年龄、性别、体质指数(BMI)、吸烟情况等]、FeNO值、血EOS值、中性粒细胞数(NES)、肺功能参数(FEV1/FVC)、COPD评估测试(CAT)评分,归总数据进行统计学分析。结果 B组的血EOS%高于A组,差异有统计学意义(P<0.001),A组的NES值高于B组,差异有统计学意义(P<0.001);两组组间FeNO(P=0.457)、FEV1/FVC(P=0.166)、CAT评分(P=0.114)差异均无统计学意义。A组患者的FeNO值与血EOS%(P=0.870)、FEV1/FVC(P=0.255)、CAT评分(P=0.962)、NES(P=0.611)均无相关性。B组患者的FeNO值与血EOS%呈正相关(r=0.343,P=0.001),与FEV1/FVC(P=0.903)、CAT评分(P=0.617)、NES(P=0.836)均无相关性。结论 在血EOS水平较低时(EOS%<2%),稳定期COPD患者FeNO值与血EOS%无明显相关性;在血EOS水平较高时(EOS%≥2%),稳定期COPD患者FeNO值与血EOS%呈正相关,一定程度上能反映患者气道EOS炎症情况,在COPD的诊疗中具有一定的应用价值。Objective To explore the correlation between exhaled nitric oxide(FeNO)and different levels of eosinophils(EOS)in patients with stable chronic obstructive pulmonary disease(COPD)and its clinical application value.Methods A retrospective analysis was conducted on 187 stable COPD patients admitted to Peking University Shenzhen Hospital.They were divided into groups A and B based on whether the EOS percentage was greater than 2%(group A with EOS%<2%and group B with EOS%≥2%).Basic information concluded(age,gender,body mass index(BMI),smoking status,etc.),FeNO value,blood EOS value,neutrophil count(NES),lung function parameters(FEV1/FVC).The COPD assessment test(CAT)scores were collected and statistically analyzed.Results The blood EOS%of Group B was higher than that of Group A,with a statistically significant difference(P<0.001).The NES value of Group A was higher than that of Group B,with a statistically significant difference(P<0.001);There was no statistically significant difference in FeNO(P=0.457),FEV1/FVC(P=0.166),and CAT score(P=0.114)between the two groups.The FeNO value of Group A patients was not correlated with blood EOS%(P=0.870),FEV1/FVC(P=0.255),CAT score(P=0.962),and NES(P=0.611).The FeNO value of Group B patients was positively correlated with blood EOS%(r=0.343,P=0.001),but not with FEV1/FVC(P=0.903),CAT score(P=0.617),and NES(P=0.836).Conclusion When the blood EOS level is low(EOS%<2%),there is no significant correlation between the FeNO value and blood EOS%in stable COPD patients.When the blood EOS level is high(EOS%≥2%),the FeNO value of stable COPD patients is positively correlated with the blood EOS%,which can reflect the airway EOS inflammation of patients to a certain extent and has certain application value in the diagnosis and treatment of COPD.

关 键 词：呼出气一氧化氮 慢性阻塞性肺疾病 血嗜酸性粒细胞百分比 肺功能 CAT评分 

分 类 号：R563[医药卫生—呼吸系统]