一氧化氮呼气测定在支气管哮喘诊疗中的应用探讨

Application of measurement of exhaled nitric oxide level in diagnosis and treatment of bronchial asthma

目的探讨一氧化氮呼气测定在支气管哮喘诊断和治疗中的应用价值。方法选取我院收治的支气管哮喘患者70例,选取40例健康者为对照组。分别给予患病组和对照组肺功能及呼出气一氧化氮的浓度测定。所有患者住院期间以甲泼尼龙、氨茶碱等行常规治疗3-7天,出院后以沙丁胺醇及沙美特罗替卡松粉吸入剂维持治疗,测定治疗1个月、3个月、6个月后测定者肺功能及一氧化氮呼气水平。结果患病组治疗后1个月、3个月、6个月的一氧化氮呼气水平明显低于治疗前,差异有统计学意义(P<0.05),治疗后1个月、3个月、6个月之间比较差异有统计学意义(P<0.05),治疗后6个月与对照组比较差异无统计学意义(P>0.05)。治疗后1个月、3个月、6个月的FEV1%水平与治疗前比较有明显改善,差异具有统计学意义(P<0.05),治疗后6个月与对照组比较差异无统计学意义(P>0.05)。结论在支气管哮喘诊疗中,一氧化氮可以作为气道炎症严重程度的重要指标,其简单方便、无创、可重复性好,对支气管哮喘诊断及治疗具有十分重要的临床意义。

Objective To investigate the application value of measurement of exhaled nitric oxide level in the diagnosis and treatment of bronchial asthma. Methods Seventy patients with bronchial asthma admitted to our hospital were selected as case group, while 40 healthy controls were selected as control group. The pulmonary function was evaluated, and the concentration of exhaled nitric oxide was determined. All patients received conventional treatment with methylprednisolone and aminophylline for 3 -7 d during hospitalization and received maintenance treatment with salbutamol and salmeterol and fluticasone propionate powder for inhalation after discharge. After 1, 3, and 6 months of treatment, the pulmonary function and exhaled nitric oxide levels of all subjects were measured. Results The case group showed significant decreases in exhaled nitric oxide level after 1, 3, and 6 months of treatment （P〈0.05）, and there were significant differences between the values at months 1, 3, and 6 （P〈0.05）; the exhaled nitric oxide level of the case group after 6 months of treatment was not significantly different from that of the control group （P〉0.05）. After 1, 3, and 6 months of treatment, the case group showed significant improvements in forced expiratory volume in 1 second percentage （FEV1%） （P〈0.05）; after 6 months of treatment, the case group was not significantly from the control group in terms of FEV1% （P〉0.05）. Conclusion The concentration of exhaled nitric oxide can be used as an important indicator of the severity of airway inflammation; it is easy to determine, with noninvasiveness and good repeatability, and is thus of great clinical significance for the diagnosis and treatment of bronchial asthma.