呼出气一氧化氮检测与慢性阻塞性肺疾病严重程度的相关性分析  

Correlation Between Fractional Exhaled Nitric Oxide and Disease Severity of Chronic Obstructive Pulmonary Disease

作　　者：李智慧 许林[1] 赵秀芬 徐静[1] 王波[1] 刘益 杨张奎 黄艳香 张萍 LI Zhihui;XU Lin;ZHAO Xiufen;XU Jing;WANG Bo;LIU Yi;YANG Zhangkui;HUANG Yanxiang;ZHANG Ping(Department of Respiratory,The Fifth Affiliated Hospital of Kunming Medical University,Gejiu 661000,China)

机构地区：[1]昆明医科大学第五附属医院呼吸与危重症医学科,个旧661000

出　　处：《中国医药指南》2024年第8期84-87,共4页Guide of China Medicine

摘　　要：目的 探讨呼出气一氧化氮(fraction of exhaled nitric oxide,FeNO)水平与慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)严重程度的相关性。方法 选择2017年9月—2019年9月就诊于昆明医科大学第五附属医院的稳定期COPD患者178例及同期体检健康志愿者43例,分别进行FeNO稳态浓度及肺功能检测,记录第1秒用力呼气容积(FEV1)及第1秒用力呼气容积占预计值百分比(FEV1%pred)。依据COPD患者气流受限肺功能分级分成GOLD 1级(n=30)、2级(n=78)、3级(n=40)、4级(n=30)四个亚组;然后再根据慢阻肺综合评估分成A组(n=50)、B组(n=34)、C组(n=46)、D组(n=48)四个亚组,比较COPD病例组与健康组以及各个亚组之间的Fe NO水平,并分析Fe NO与FEV1、FEV1%pred的相关性。结果 (1)稳定期COPD组的FeNO水平高于健康组(P <0.05)。(2) COPD患者FeNO与FEV1、FEV1%pred均无相关性(P> 0.05),GOLD1级、2级、3级、4级不同亚组的FeNO水平比较差异无统计学意义(P> 0.05)。(3)慢阻肺综合评估C组的FeNO水平高于A组(P <0.05),其余各组间FeNO值比较差异无统计学意义(P> 0.05)。结论 FeNO检测不能替代肺功能、慢阻肺综合评估分级,对COPD患者病情需进行单独评估,但FeNO检测可能有助于COPD的初筛诊断及未来急性加重风险预测。Objective To explore the correlation between fractional exhaled nitric oxide(FeNO)level and the severity of chronic obstructive pulmonary disease(COPD).Methods From September 2017 to September 2019,178 patients with stable COPD and 43 healthy volunteers in the hospitalcheck-up were selected.The steady-state FeNO concentration and pulmonary function were measured,and forced expiratory volume in one second(FEV1)and forced expiratory volume in one second as a percentage of predicted value(FEV1%pred)were recorded.Patients with COPD were divided into four subgroups according to the pulmonary function classification of airflow limitation:GOLD grade 1(n=30),GOLD grade 2(n=78),GOLD grade 3(n=40)and GOLD grade 4(n=30).Then,according to the comprehensive assessment of COPD,they were divided into four subgroups:group A(n=50),group B(n=34),group C(n=46)and group D(n=48).The differences in FeNO levels between patients with COPD and healthy groups were compared,as well as the subgroups of COPD,and the correlation between FeNO and FEV1 and FEV1%pred was analyzed.Results①FENO was significantly higher in the stable than healthy case(P<0.05).②There was no significant correlation between FeNO and FEV1 and FEV1%pred in COPD patients(P>0.05).There was no significant difference in FeNO levels among GOLD 1,GOLD 2,GOLD 3 and GOLD 4(P>0.05).③FeNO level in group C of the comprehensive assessment were higher than those in group A(P<0.05).While there was no statistical difference in FeNO levels among the other subgroups(P>0.05).Conclusions FeNO testing cannot replace pulmonary function and COPD comprehensive assessment grouping,which can be used to separately assess the degree of airway obstruction and dyspnea,but it may be helpful for the primary diagnosis of COPD and the prediction of the risk of acute exacerbation in the future.

关 键 词：慢性阻塞性肺疾病 呼出气一氧化氮 肺功能 疾病严重程度 

分 类 号：R563.9[医药卫生—呼吸系统]