糖皮质激素吸入对咳嗽变异性哮喘患者呼出气NO水平的影响

Effects of inhaled corticoids on the fractional exhaled NO levels in cough variant asthma patients

目的观察咳嗽变异性哮喘(CVA)患者呼出气NO(FeNO)水平与气道炎症水平的关系,以及糖皮质激素对其的影响,并探讨其水平变化与气道炎症水平的关系。方法经支气管激发试验确诊的CVA患者14例,予以布地奈德/福莫特罗吸入剂吸入治疗,分别于治疗前及治疗6个月后测定其引起FEV1降低20%的乙酰甲胆碱浓度(PC20FEV1)、FeNO水平、诱导痰中嗜酸性粒细胞量及比例。结果 FeNO水平显著高于健康对照者,与PC20FEV1水平呈显著负相关,而与诱导痰嗜酸性粒细胞比例呈显著正相关。经布地奈德/福莫特罗吸入治疗6个月后气道反应性逐渐下降,其诱导痰中嗜酸性粒细胞比例亦显著下降。结论CVA患者FeNO水平显著升高,且此变化与患者气道炎症水平显著相关,而经吸入性糖皮质激素长效β2受体激动剂的联合制剂(ICS/LABA)治疗后,其水平显著下降,提示FeNO也许可以作为CVA患者气道炎症控制水平的标志。

Objective To investigate the relationship between the levels of fractional exhaled NO and airway inflammation cells in cough variant asthma（CVA）and the effect of inhaled corticoids .Methods CVA patients were treated with Budesonide and Formoterol Fumarate Powder for Inhalation for 6 months .Before and after treatment ,the provocative concentration of methacholine causing a 20% fall in forced expiratory volume in one second（PC20 FEV1 ）was tested ,and the levels of fractional exhaled No ,and eo‐sinophil in induced sputum were examined .Results The levels of FeNO ,the percentage of eosinophil in induced sputum were sig‐nificantly higher than control healthy subjects ,and all decreased significantly after treated with ICS/LABA ,together with elevated PC20 FEV1 .The levels of FeNO were significantly correlated with the percentage of eosinophil in induced sputum ,and also negative‐ly correlated to PC20 FEV1 .Conclusion The levels of FeNO in CVA patients were significantly higher than control healthy sub‐jects ,and correlated with the inflammation of airway ,so FeNO may be used as a biomarker to determine the control level of airway inflammation in CVA patients .