吸烟对慢性气道炎症患者FeNO表达的影响

The influence of smoking on FeNO expression in patients with chronic airway inflammation

目的探讨吸烟对慢性气道炎症患者呼出气一氧化氮(Fe NO)表达的影响。方法 206例患者根据临床病史及肺功能特点,分为慢性阻塞性肺病-哮喘重叠综合征(ACOS)组37例、慢性阻塞性肺病(COPD)组124例、哮喘组45例。将健康体检者40例作为对照组。然后根据吸烟情况将4组内人群划分为吸烟者与不吸烟者。比较4组间Fe NO值、肺功能指标,同时比较4组内吸烟、不吸烟者的Fe NO值;将每组吸烟者的吸烟指数与Fe NO值进行相关性分析。结果 (1)ACOS组与哮喘组Fe NO值明显高于COPD组与对照组(32.6±9.9、37.6±10.9 vs 18.7±9.8、14.4±4.3,F=68.082,P<0.05),而ACOS组与哮喘组、COPD组与对照组Fe NO值比较差异无统计学意义。(2)ACOS组、COPD组、哮喘组的1秒用力呼气量占预计值百分比(FEV1%)、1秒用力呼气量占用力肺活量的百分比(FEV1/FVC)均低于对照组,ACOS组、COPD组的FEV1/FVC显著低于哮喘组(P<0.05),ACOS组、COPD组、哮喘组的FEV1%无明显差异(P>0.05)。(3)COPD组、ACOS组吸烟者Fe NO值均明显低于不吸烟者(P<0.05),哮喘组、对照组吸烟者与不吸烟者Fe NO值无显著性差异(P>0.05)。(4)COPD组吸烟指数与Fe NO值呈明显负相关,其他组则无明显相关关系。结论吸烟可以导致COPD、ACOS患者的Fe NO值降低,检测Fe NO有助于鉴别COPD合并哮喘情况。

Objective To discuss the influence of smoking on fractional exhaled nitric oxide （FeNO） expression in pa- tients with chronic airway inflammation. Methods According to the clinical history and characteristics of lung function, 206 patients were divided into asthma and chronic obstructive pulmonary disease （COPD） overlap syndrome （ACOS） group （n=37）, COPD group （n=124） and asthma group （n=45）. Meanwhile, 40 people accepted healthy physical examination were used as the control group （n=40）. Then persons were sub-divided into smokers or nonsmokers according to the situation of smoking. The FeNO value and pulmonary function index were compared between the four groups, and the FeNO value was compared between smokers and nonsmokers respectively. The smoking index and FeNO value of smokers were measured for correlation analysis. Results （1）The FeNO values were significantly higher in ACOS group and asthma group than those of COPD group and the control group （32.6±9.9 and 37.6±10.9 vs 18.7±9.8 and 14.4±4.3, F=68.082, P 〈 0.05）. However, there were no significant differences in FeNO value between ACOS group and asthma group, and between COPD group and the control group. （2） The FEV1/FVC was significantly lower in ACOS group, COPD group and asthma group than that of control group, while the FEV1/FVC was significantly lower in ACOS group and COPD group than that of asthma group （P 〈 0.05）. There was no significant difference in FEVI% between ACOS group, COPD group and asthma group （P 〉 0.05）. （3） The Fe- NO value was significantly lower in smokers of COPD group and ACOS group than that of non-smokers （P 〈 0.05）. However, there was no significant difference in FeNO value between smokers and nonsmokers in asthma group and the control group （P 〉 0.05）. （4）The smoking index and FeNO value were negatively correlated in COPD group, but there were no obvious cor- relation in smoking index and FeNO values between other groups. Conclusion Smoking can lead to the reduction of FeNO value in COPD and ACOS patients. The detection of FeNO is heloful for the differentiatinz COPD combined asthma.