评估FeNO水平对奥马珠单抗在重度过敏性哮喘患者早期治疗疗效的预测能力  

Evaluation of FeNO as a predictor of early response to omalizumab in patients with severe allergic asthma

作　　者：雷莉娟 陈亮 张博瑞 薛克营 张劲农 蔡荧煌 LEI Lijuan;CHEN Liang;ZHANG Borui;XUE Keying;ZHANG Jinnong;CAI Yinghuang(Department of Pulmonary and Critical Medicine,Xiamen Chang Gung Hospital,Allergy Center,Xiamen,Fujian 361026,China;Department of Respiratory Diseases,Chang Gung Memorial Hospital at Linkou,Taiwan 000333,China;Xiamen Second Hospital affiliated to Xiamen Medical College,Xiamen Respiratory Hospital,Xiamen,Fujian 361021,China;Department of Respiratory Medicine,Xiamen Humanity Hospital,Xiamen,Fujian 361026,China)

机构地区：[1]厦门长庚医院呼吸与危重症医学科过敏中心,福建厦门361026 [2]林口長庚紀念醫院呼吸胸腔科系呼吸道疾病科,中国台湾000333 [3]厦门医学院附属厦门第二医院厦门呼吸病医院,福建厦门361021 [4]厦门弘爱医院呼吸内科,福建厦门361026

出　　处：《临床肺科杂志》2023年第11期1625-1628,共4页Journal of Clinical Pulmonary Medicine

基　　金：福建省科技计划项目(No.2020D021)。

摘　　要：目的评估呼出气一氧化氮(FeNO)水平对奥马珠单抗(Omalizumab)在重度过敏性哮喘患者早期治疗疗效的预测能力。方法收集从2019年3月1日至2021年7月31日期间自厦门长庚医院呼吸与危重症医学科接受Omalizumab治疗的重度过敏性哮喘患者44例,行FeNO及肺功能检查,采用Omalizumab 300mg每4周皮下注射的方案,治疗12周后,观察控制情况并评估影响疗效的因素。结果经过单因素卡方检验以及独立样本非参数检验分析,影响治疗早期(12周)疗效的因素为FeNO水平(P<0.001)、FEV_(1)%(P=0.008)、FEV_(1)/FVC(P=0.035)、PEF_(25%-75%)(P=0.032);而性别、年龄、是否多重过敏并不影响治疗的早期疗效。经过多因素二元Logistic回归分析,治疗前基线FeNO水平是影响Omalizumab在重度过敏性哮喘患者早期治疗有效的独立影响因子(OR:1.052;95%CI:1.008~1.098)。结论患者治疗前基线FeNO水平是作为影响Omalizumab在重度过敏性哮喘患者早期治疗疗效的独立影响因子。对于治疗前FeNO水平增高(≥23.5ppb)的患者,使用Omalizumab可获得早期哮喘控制。Objective To evaluate the predictive power of fractional exhaled nitric oxide(FeNO)level for early treatment of Omalizumab in patients with severe allergic asthma.Methods A total of 44 patients with severe allergic asthma who had been treated with Omalizumab from March 1,2019 to July 31,2021 in the Department of Respiratory and Critical Care Medicine of Xiamen Chang-Gung Hospital were enrolled.FeNO and pulmonary function tests were performed,and Omalizumab 300mg was injected subcutaneously every 4 weeks.After 12 weeks of treatment,the control status was observed and the factors affecting the efficacy were evaluated.Results Chi-square test and independent nonparametric test analysis revealed that FeNO level(P<0.001),FEV 1%(P=0.008),FEV 1/FVC(P=0.035)、PEF 25%-75%(P=0.032)were the contributing factors to the early effect of Omalizumab treatment;whereas,gender,age,and allergic status did not affect the early efficacy of treatment.Multivariate binary Logistic regression analysis showed that the baseline level of FeNO before treatment was an independent factor affecting the early treatment efficacy of Omalizumab(OR:1.052;95%CI:1.008~1.098).Conclusion The baseline FeNO level before treatment is an independent contributing factor for the early efficacy of Omalizumab in patients with severe allergic asthma.Early asthma control could be achieved with Omalizumab treatment in patients with elevated FeNO levels(≥23.5 ppb).

关 键 词：呼出气一氧化氮 奥马珠单抗 早期疗效 独立影响因子 

分 类 号：R562.25[医药卫生—呼吸系统]