测定慢性阻塞性肺疾病患者呼出气一氧化氮的临床意义

Clinical significance of fractional exhaled nitric oxide test in patients with chronic obstructive pulmonary disease

目的探讨呼出气一氧化氮(fraction of exhaled nitric oxide,FENO)测定在慢性阻塞性肺疾病(chronic ob-structive pulmonary disease,COPD)患者诊治中的临床意义。方法 2011年6月至2012年10月诊断为支气管哮喘和慢性阻塞性肺疾病患者及健康对照组共81例。对所有研究者均进行FENO检测及肺功能测定,评估3组患者FENO水平差别及与肺功能的相关性。结果三组入选者中稳定期COPD患者FENO水平(36.31±11.78)ppb低于哮喘组(74.12±12.34)ppb,高于健康对照组(17.78±12.25)ppb,差异均具有统计学意义。稳定期COPD患者FENO值与健康对照组FENO值间存在重叠。稳定期COPD患者FENO水平与FEV1%pred呈负相关(r=-0.715,P<0.01)。结论测定FENO值不能作为诊断COPD的指标,然而可作为一个早期的提示COPD患者肺损伤程度的一个很好的指标。

Objective To explore The clinical significance of fractional exhaled nitric oxide test in patients with chronic obstructive pulmonary disease. Methods Patients With chronic obstructive pulmonary disease,asthma and normal control group were studied, spirometry and FENO test were performed in all subjects, assess the FENO level difference and the correlation with spirometry and FENO level in 3 groups of patients. Results Subjects with stable COPD had significantly higher values of FENO than controls （36. 31 ± 11.78 vs 17. 78 ± 12. 25 ; P 〈 0. 05 ） but lower than the subjects with asthma （36. 31 ± 11.78 vs 74. 12 ± 12. 34 P 〈0. 05）. The FENO values in COPD subjects were inversely related to the FEV1/pred% ratio. There was a significant overlap between the FENO values in COPD and the control subjects. Conclusions FENO value cannot be used as a diagnostic index of COPD,but can be used as a good indicator to indicate the pulmonary injury severity in COPD patient.