FeNO检测在评价老年支气管哮喘疗效中的应用价值

Application Value of FeNO Detection in Evaluation of Efficacy in Elderly Patients with Bronchial Asthma

目的分析呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)水平对老年支气管哮喘治疗效果的评估价值。方法选取120例老年支气管哮喘患者(急性发作期组74例、缓解期组46例)及60例健康老年人(对照组)作为研究对象,对比3组第1秒用力呼气容积(FEV1)占预计值的百分比、FEV1/用力肺活量(FVC)值及FeNO值差异,并分析急性发作期患者治疗前、后不同时间的肺功能指标、哮喘控制(ACT)评分及FeNO水平的变化情况。结果急性发作期组FEV1%、FEV1/FVC水平明显低于缓解期组和对照组(P<0.05),FeNO水平明显高于缓解期组和对照组(P<0.05);缓解期组FEV1%、FEV1/FVC水平明显低于对照组(P<0.05),FeNO水平明显高于对照组(P<0.05)。急性发作期老年支气管哮喘患者治疗后1、3、6个月的FEV1%、FEV1/FVC、ACT评分均较治疗前明显升高(P<0.05),FeNO水平较治疗前明显降低(P<0.05)。急性发作期老年支气管哮喘患者的FeNO水平与ACT评分呈负相关(r=-0.519,P<0.001)。结论 FeNO是反映老年支气管哮喘急性期炎症损伤的重要指标,其变化对于评估哮喘的临床转归具有重要参考价值。

Objective To analyze the evaluation value of fractional exhaled nitric oxide（FeNO）in treatment of elderly patients with bronchial asthma.Methods 120 cases of elderly patients with bronchial asthma（acute exacerbation（n=74）,and remission stage（n=46）and 60 healthy old people（control group）were selected and their respective first second forced expiratory volume（FEV1）,FEV1/（FVC）values and FeNO values were compared and changes of lung function,asthma control score（ACT）and FeNO values before and after treatment in patients with acute exacerbation were analyzed.Results FEV1% and FEV1/FVC of acute group were significantly lower than the remission group and the healthy controls（P〈0.05）and the FeNO level of acute group was significantly higher than that in remission and healthy group（P〈0.05）;FEV1% and FEV1/FVC in remission group were significantly lower than those in healthy group（P〈0.05）,and significantly higher in FeNO level than healthy controls（P〈0.05）.After 1month,3months and 6months of treatment,the FEV1%,FEV1/FVC and ACT scores in acute group were significantly higher;and its FeNO level were significant decreased than those measured before treatment（P〈0.05）.FeNO level in acute group（n=74）had a negative correlation with ACT score（r=-0.519,P〈0.001）.Conclusion FeNO level is an important parameter in reflecting acute exacerbation of elderly patients with bronchial asthma,whose change can provide valuable reference to evaluating clinical outcome of asthma.