呼出气一氧化氮在咳嗽变异性哮喘诊断和治疗中的临床价值

Clinical significance of fractional exhaled nitric oxide in diagnosis and therapy for cough variant asthma

目的探讨呼出气一氧化氮（FeNO）在咳嗽变异性哮喘（CVA）诊断和治疗中的临床价值。方法选取30例CVA患者（CVA组）和30例健康者（对照组），分别检测两组患者的FeNO水平、诱导痰液中嗜酸粒细胞百分比（EOS％）和1秒用力呼气容积（FEV1）／用力肺活量（FVC）并进行比较，分析FeNO水平与诱导痰液中EOS％和FEV1／FVC的相关性。结果与对照组相比，CVA组FeNO水平和诱导痰液中EOS％明显升高（P〈0．01），而两组间FEV1／FVC比较，差异无统计学意义（P〉0．05）。与治疗前相比，治疗8周后CVA组FeNO水平和诱导痰液中EOS％明显降低（P〈0．01），而FEV1／FVC无明显变化（P〉0．05）。CVA患者FeNO水平与FEV1／FVC之间无相关性（r=-0．160，P〉0．05），而与诱导痰液中EOS％呈正相关（r=0．437，P〈0．01）。结论CVA患者FeNO升高，并与诱导痰液中EOS％相关。FeNO水平测定有助于CVA的早期诊断和疗效评估。

Objective To explore the clinical significance of fractional exhaled nitric oxide （FeNO） in diagnosis and therapy for cough variant asthma（CVA）.Methods 30 patients with CVA（CVA group） and 30 cases of healthy controls （control group） were enrolled. The levels of FeNO, induced sputum eosinophils ratio（ EOS% ） and forced expiratory volume in one second （FEV1 ）/forced vital capacity （FVC） were measured in all subjects,and their correlation were analyzed.Results The FeNO level and induced sputum EOS% of CVA group was significantly higher than control group（P 〈0. 01 ）. There was no significant difference of FEV1/FVC between two groups. The FeNO level and induced sputum EOS% of CVA group 8 weeks after therapy decreased significantly than before therapy （P 〈 0. 01 ）, while FEV1/FVC did not change. In CVA patients, FeNO level was not associated with FEV1/FVC（r = -0. 160,P 〉0.05） ,but positive related with EOS% （r =0.437, P 〈 0.01 ）. Conclusion The FeNO level increases in CVA patents and is related with EOS%. Measurement of FeNO is helpful to early diagnosis and therapeutic effect evaluation of therapy of CVA.