支气管哮喘患者呼出气一氧化氮与肺功能、诱导痰及外周血嗜酸性粒细胞比例等指标的相关性分析及其临床意义

Correlation of fractional exhaled nitric oxide with lung function and sputum eosinophils in asthm a patients

目的观察哮喘患者呼出气一氧化氮(FeNO)水平,探讨其与肺功能指标第1秒用力呼气量(FEV1)占预计值百分比、诱导痰及外周血嗜酸性粒细胞(EOS)比例、血清总Ig E(TIgE)及哮喘控制试验(ACT)评分等指标的关系及其临床意义。方法选择呼吸内科门诊的哮喘患者99例(观察组)及门诊健康体检者90例(对照组),采用NIOX MINO分析仪、德国Jeager Master Screen系列肺功能仪、SYSMEX五分类血液分析仪及酶联免疫法分别检测入选者Fe NO水平、肺功能、外周血EOS百分比及TIg E;应用光学显微镜做细胞计数及分类检测诱导痰EOS百分比;应用ACT评分表评估哮喘控制程度。采用Pearson直线相关分析Fe NO与其他指标的相关性。结果观察组Fe NO水平、诱导痰及外周血EOS百分比和TIg E均高于对照组,FEV1占预计值百分比低于对照组,差异均有统计学意义(均P<0.01)。观察组Fe NO水平与FEV1占预计值百分比、ACT评分均无相关性(r=0.004、-0.195,均P>0.05),与血EOS百分比、TIg E、诱导痰EOS百分比均呈正相关(r=0.315、0.305、0.473,均P<0.01)。结论哮喘患者Fe NO水平明显升高,可反映哮喘患者气道炎症水平,尤其是EOS炎症。

Objective To investigate the correlation of fractional exhaled nitric oxide （FeNO） with lung function, sputum eosinophils, blood eosinophils, blood total IgE （TIgE） and asthma control test （ACT） score in asthma patients. Methods The levels of FENO, FEV1% pred, sputum eosinophils, blood eosinophils and TIgE were measured in 99 asthmatic out-patients （study group） and 90 healthy subjects （control group）. The correlation of FeNO level with FEV1% pred, ACT scores, sputum eosinophils, blood eosinophils and TIgE was analyzed with Pearson correlation coefficient. Results The levels of FeNO, blood eosinophils,sputum eosinophils and TIgE in study group were significantly high and FEVl%Pred was significantly lower than those in control group （all P〈0.01）. FeNO level was positively correlated with sputum eosinophils （r=0.473, P〈0.05）, blood eosinophils （r=0.315, P〈0.05） and TIgE （r=0.305, P〈0.05）, but not correlated with FEV~%Pred （r=0.004, P 〉0.05）and ACT scores（r=-0.195, P 〉0.05）. Conclusion The level of FeNO is increased in asthma patients, which can reflect the extent of air- way inflammatory, especially esoinophilic airway inflammation.