呼出气一氧化氮测定预测吸入性糖皮质激素对慢性阻塞性肺疾病治疗效果的价值研究

呼出气一氧化氮测定预测吸入性糖皮质激素对慢性阻塞性肺疾

病治疗效果的价值研究

吴成明;雷撼;胡云倩;谢伟见;付敏

【期刊名称】《临床和实验医学杂志》

【年(卷),期】2018(017)012

【摘要】目的研究呼出气一氧化氮(FeNO)测定预测吸入性糖皮质激素(ICS)对慢性阻塞性肺疾病治疗效果的价值.方法前瞻性选取80例稳定期慢性阻塞性肺疾病患者作为研究对象,检测FeNO值,其中FeNO阳性(观察组)和FeNO阴性(对照组)各40例.两组患者均给予ICS治疗,通过统计学方法分析两组患者治疗前后第1秒用力呼气容积(FEV1)改善率的情况,并预测ICS对FeNO阳、阴性患者的疗效.结果两组患者性别构成比、年龄、体质量指数(BMI)及吸烟史和肺功能分级的比较,均无显著差异(P>0.05).FeNO值与患者给予ICS治疗后FEV1的改善存在明显关系(r=0.77,P<0.01).相比对ICS治疗无反应者(FEV1增加<200ml),治疗有反应者(FEV1增加≥200ml)的FeNO值显著升高(P<0.05).FeNO值对预测患者ICS有无反应的受试者工作特征(ROC)曲线下面积为0.92,阈值为29.08nmol.结论 FeNO 值可作为预测稳定期慢性阻塞性肺疾病患者ICS治疗效果的重要指标,其与患者肺功能损伤程度并无显著相关性,但与患者气道炎症程度密切相关,可用于反映患者气道类型及其严重程度,因此具有良好的临床应用价值.%Objective To study the value of fraction of exhaled nitric oxide (FeNO)in inhaled corticosteroid (ICS)treatment of chronic obstructive pulmonary disease. Methods 80 cases of stable chronic obstructive pulmonary disease were selected as the research objects,the value of FeNO was detected,and they were divided

into FeNO positive patients (observation group)and FeNO negative patients (control group),with 40 cases in each group. Two groups were given ICS treatment and statistical analysis was performed to analyze the improvement rate of forced expir-atory volume in one second(FEV1)before and after treatment in two groups,and predicted FeNO positive and negative effects to ICS. Results The ages,gender,body mass index (BMI)and history of smoking and lung function grading of the two groups showed no significant difference (P>0.05). There was significant correlation between FeNO and improving of FEV1 after ICS treatment (r=0.77,P<0.01). Compared to no -responders in the treatment of ICS

(FEV1increasing<200ml),the FeNO value in treatment responders

(FEV1increasing≥200ml)significantly increased (P<0.05). The receiver operating characteristic (ROC)area under the curve for FeNO on the prediction of ICS whether showed re-sponse or not was 0. 92,with the threshold of 29.08nmol. Conclusion FeNO value can be used as an important predictor for patients with stable chronic obstructive pulmonary disease in the treatment of ICS,and showed no correlation with the damage with pulmonary function,but is closely re-lated with the degree of inflammation in airway,which can be used to reflect the types and severity,so it has good clinical application value.

【总页数】4页(P1332-1335)

【作者】吴成明;雷撼;胡云倩;谢伟见;付敏

【作者单位】同济大学附属东方医院呼吸科上海 200120;上海市闵行区中西医结合医院呼吸科上海 200241;同济大学附属东方医院呼吸科上海 200120;同济大学附属东方医院呼吸科上海 200120;上海市闵行区中西医结合医院呼吸科上海200241;上海市闵行区中西医结合医院呼吸科上海 200241

【正文语种】中文

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