FeNO水平在哮喘-慢性阻塞性肺疾病重叠治疗前后的变化及与气道炎症的关系
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摘要
目的探讨呼出气NO(FeNO)水平在哮喘-慢性阻塞性肺疾病重叠(ACO)治疗前后的变化及其与气道炎症初筛指标间的关系。方法选择ACO患者52例为研究组,以上病例均给予ICS/LABA规范治疗,分别于治疗前后进行FeNO检测,同时采集外周血清总IgE、嗜酸性粒细胞百分比(EOS%)等指标,了解治疗前后FeNO水平、血清IgE及EOS的变化,以同期健康志愿人群(30例)为对照组;分析ACO病人FeNO水平与血清IgE、EOS等指标的关系。结果ACO病人FeNO水平与对照组比较,显著增高(P<0.05),经应用ICS/LABA规范治疗12周后,ACO病人FeNO水平较治疗前显著下降(P<0.05);Pearson相关分析表明FeNO与血清IgE浓度、嗜酸性粒细胞百分比均呈正相关(r值分别为:0.641、0.391,P<0.01)。结论ACO病人经激素+β2受体激动剂规范治疗后FeNO水平均显著降低,此变化同病人气道炎症变化具有较好相关性。
Objective To explore the relationship between the changes of exo-breath NO( Fe NO) level before and after treatment of asthma-chronic obstructive pulmonary disease( ACO) and the initial screening index of airway inflammation. Methods 52 patients with ACO were selected as the research group,and they were given ICS/LABA specification. The level of Fe NO was detected before and after treatment,and their total Ig E,Fe NO and EOS% in peripheral blood were collected at the same time. The changes of serum Ig E,Fe NO and EOS were analyzed before and after treatment. Another 30 healthy volunteers during the same period were taken as the control group. The relationship of Fe NO level with serum Ig E and EOS in ACO patients was analyzed. Results The level of Fe NO in the research group was significantly higher than that in the control group( P < 0. 05). After 12 weeks of standard application of ICS/LABA,the level of Fe NO in ACO was significantly lower than before treatment( P < 0. 05). Pearson correlation analysis showed that Fe NO had positive correlation with serum Ig E concentration and eosinophil percentage( r value: 0. 641,0. 391,P < 0. 01). Conclusion The level of Fe NO decreases significantly after the treatment of ACO by hormone + β2 agonists,which has a good correlation with the patients' airway inflammation.
Objective To explore the relationship between the changes of exo-breath NO( Fe NO) level before and after treatment of asthma-chronic obstructive pulmonary disease( ACO) and the initial screening index of airway inflammation. Methods 52 patients with ACO were selected as the research group,and they were given ICS/LABA specification. The level of Fe NO was detected before and after treatment,and their total Ig E,Fe NO and EOS% in peripheral blood were collected at the same time. The changes of serum Ig E,Fe NO and EOS were analyzed before and after treatment. Another 30 healthy volunteers during the same period were taken as the control group. The relationship of Fe NO level with serum Ig E and EOS in ACO patients was analyzed. Results The level of Fe NO in the research group was significantly higher than that in the control group( P < 0. 05). After 12 weeks of standard application of ICS/LABA,the level of Fe NO in ACO was significantly lower than before treatment( P < 0. 05). Pearson correlation analysis showed that Fe NO had positive correlation with serum Ig E concentration and eosinophil percentage( r value: 0. 641,0. 391,P < 0. 01). Conclusion The level of Fe NO decreases significantly after the treatment of ACO by hormone + β2 agonists,which has a good correlation with the patients' airway inflammation.
引文
[1]陈明勇,吴友茹,朱静,等.血清总Ig E和Fe NO在哮喘-慢性阻塞性肺疾病重叠综合征患者的表达水平及临床诊断意义[J].临床和实验医学杂志,2016,15(22):2237-2240.
[2]中华医学会呼吸病学分会哮喘学组,中华医学会全科医学分会.中国支气管哮喘防治指南(基层版)[S].中华结核和呼吸杂志,2013,36(5):331-336.
[3]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[S].中华结核和呼吸杂志,2013,36(4):255-264.
[4]李少霞,梁志华,陈琳.呼出气一氧化氮在哮喘-慢性阻塞性肺疾病重叠综合征诊治中的意义[J].广州医科大学学报,2017,45(2):16-20.
[5] PETSKY H L,CATES C J,LASSERSON T J,et al. A systematicreview and meta-analysis:Tailoring asthma treatment on eosinophilic markers(exhaled nitric oxide or sputumeosinophils)[J]. Thorax,2012,67(3):199-208.
[6] HIZAWA N. Clinical approaches towards asthma and chronic obstructive pulmonary disease based on the heterogeneity ofdisease pathogenesis[J]. Clin Exp Allergy,2016,46(5):678-687.
[7] PETSKY H L,KEW K M,TURNER C,et al. Exhaled nitric oxide levels to guide treatment for adults with asthma[J]. Cochrane Database Syst Rev,2016,9:CD011440.
[8]毛山,殷凯生.支气管哮喘患者痰中细胞因子水平的变化[J].临床肺科杂志,2013,18(10):1772-1773.
[2]中华医学会呼吸病学分会哮喘学组,中华医学会全科医学分会.中国支气管哮喘防治指南(基层版)[S].中华结核和呼吸杂志,2013,36(5):331-336.
[3]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[S].中华结核和呼吸杂志,2013,36(4):255-264.
[4]李少霞,梁志华,陈琳.呼出气一氧化氮在哮喘-慢性阻塞性肺疾病重叠综合征诊治中的意义[J].广州医科大学学报,2017,45(2):16-20.
[5] PETSKY H L,CATES C J,LASSERSON T J,et al. A systematicreview and meta-analysis:Tailoring asthma treatment on eosinophilic markers(exhaled nitric oxide or sputumeosinophils)[J]. Thorax,2012,67(3):199-208.
[6] HIZAWA N. Clinical approaches towards asthma and chronic obstructive pulmonary disease based on the heterogeneity ofdisease pathogenesis[J]. Clin Exp Allergy,2016,46(5):678-687.
[7] PETSKY H L,KEW K M,TURNER C,et al. Exhaled nitric oxide levels to guide treatment for adults with asthma[J]. Cochrane Database Syst Rev,2016,9:CD011440.
[8]毛山,殷凯生.支气管哮喘患者痰中细胞因子水平的变化[J].临床肺科杂志,2013,18(10):1772-1773.