支气管哮喘患者呼出气一氧化氮、肺功能、ACQ7评分之间的相关性研究

Correlation between exhaled nitric oxide and lung function, ACQ7 scores in patients with bronchial asthma

目的探讨呼出气一氧化氮（FeNO）、肺通气功能及支气管哮喘（简称哮喘）控制水平的相关关系，寻找适用于哮喘患者的气道炎症监测及管理的方法。方法按GINA2008标准入选我院门诊2010年3月至2011年6月就诊65例确诊为哮喘的患者，进行FENO测定，同时测定肺功能，记录第1秒用力呼气容积（FEV1）、第1秒用力呼气容积占预计值百分比（FEV1％pred）、用力肺活量（FVC）、FEV1／FVC、呼气峰流速（PEF）、FEF25／75、FEF25／75％等指标，行诱导痰检测，记数嗜酸粒细胞的比率（EOS％）。进行哮喘控制问卷（ACQ7）及哮喘控制测试（AcT）调查表的填写。结果经多元逐步回归分析，FEN（）的值主要受到年龄、FEF25／75、FEF25／75％、日间症状的影响，与体质量指数、过敏等因素无显著相关关系，与FEV1、FEV1％pred、ACQ7评分、ACT评分等亦无显著相关（P〉0．05），FeNO与诱导痰EOS％呈显著正相关（r=0．327，P=0．022）。ACQ7与FEV1、FEV1％pred呈显著负相关（分别是r=-0．491，P=0．000，r=-0．469，P=0．012）。结论FeNO能够客观反映气道EOS炎症水平，年龄越小、日间症状越明显、小气道阻力越高，FENO水平越高。结合肺功能指标和FENO更能全面反映哮喘疾病现况及控制水平。

Objective To investigate the correlation between fraction of exhaled nitric oxide （FENO）, lung function and the level of bronchial asthma （asthma） control, looking for appropriate methods in airway inflammation monitoring and management in asthmatics. Methods A total of 65 diagnosed asthmatic out-patients since March 2010 to June 2011 according to GINA 2008 criterions were enrolled in this investigation. The patients were asked to complete FENO measurement, while pulmonary functions, recording FEV1, FEV1% pred, FVC, FEV1/FVC, PEF, FEF25/75, FEF25/75%, and collecting induced sputum, recording percent of induced sputum eosnophils cell （EOS%）. Asthma Control Qnestionnaire（ACQ7） and Asthma Control Test （ACT） were also required to finished. Results Multiple linear regression analysis showed that FENO values were affected mainly by age, FEF25/75, FEF25/ 75 %, and daytime symptoms, having no significant correlation with body mass index （BMI）, allergies or other factors, and also there was no significant correlation with FEV1 , FEV1 %, ACQ7 scores, ACT scores （ P 〉 0.05 for all）, but FENO values were significant positive correlation to induced sputum EOS% （r =0. 327, P =0. 022）. There were significantly negatively correlations between ACQ7 and FEVI , FEV1 % （respectively r = -0. 491, P =0. 000, r = -0. 469, P =0. 012）. Conclusions FENO can objectively reflect the airway eosinophilic inflammation levels. The younger, the more obvious daytime symptoms, and the higher airway resistance, the higher FENO levels. FENO combining with lung function may fully reflect the disease status and the level of asthma control.