慢性阻塞性肺疾病患者CAT评分、呼出气一氧化氮、肺功能之间的相关性研究

Correlation between CAT scores and breath nitric oxide,pulmonary function in obstructive pulmonary disease

目的:探讨慢性阻塞性肺疾病(COPD)患者生活质量及呼出气一氧化氮(Fe NO)与肺功能之间的相关性,探索一种简单、易行、准确的监测及管理COPD患者的气道炎性反应和控制情况的方法。方法:纳入81例COPD急性加重期到COPD稳定期患者及78例健康对照组,并行常规肺功能检查记录第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占预计值百分比(FEV1%pred),采用瑞典耐尔斯NIOX一氧化氮测定仪检测FENO值,对COPD患者急性加重进行CAT评分,治疗稳定后再次进行CAT评分。结果:急性加重期CAT评分显著高于稳定期,急性加重期FENO水平显著高于稳定期,急性加重期及稳定期FENO均显著高于健康对照组,差异均有统计学意义(P<0.05)。急性加重期与稳定期FENO与CAT评分均呈显著正相关,差异有统计学意义(P<0.05),急性加重及稳定期CAT评分与FEV1、FEV1%均无显著相关性,急性加重期及稳定期FENO与FEV1、FEV1%均无显著相关性,差异无统计学意义(P>0.05),但急性加重期到稳定期FEV1、FEV1%的改善与CAT评分的改善及FENO的改善均呈显著正相关性,急性加重期到稳定期CAT评分改善与FENO改善呈显著正相关,差异有统计学意义(P<0.05)。结论:FeN O可比较简单、快速地反应COPD患者的气道炎性反应及控制情况,FeN O值越高,则CAT评分越高,COPD患者生活质量越差、病情控制程度越差。FeN O结合肺功能指标及CAT评分更能全面反映COPD生活质量及控制情况。

Objective The relationship of the quality of Life、breath nitric oxide （FENO） and pulmonary function of the pa-tients in chronic obstructive pulmonary disease（ COPD）. To explore a method which can detect and manage of the patients airway nflammation and the quality of life of COPD simplify and accurately. Method Including 81 patients of acute exacerbation of the COPD to stable COPD and 78 healthy people as control group, and record first second forced expiratory volume （ FEV1 ） and orced expiratory volume in the first seconds of the percentage of the expected value（FEVl% ） tested by routine pulmonary func-tion tests. Using Nitric oxide analyzer of Sweden NIOX to detect FENO value, making CAT score of acute exacerbation of the COPD and stable period. Results Patients in acute exacerbation get higher CAT score than those in stable period obviously,pa-tients in acute exacerbation had a higher FENO level than those in stable period, people in acute exacerbation and stable period had a higher FENO level than healthy group markedly （ P 〈 0. 05 ）. Patients？ FENO and CAT score in acute and stable period showed a significant positive correlation（ P 〈0. 05） ,CAT score didn^ show a obvious correlation with FEV1 and FEV1 % in a-cute and stable period. FENO didn’t show obvious correlation with FEV1 and FEV1 % in acute and stable period （P 〉0. 05） , But the exaltation of FEV1 ~, FEV1% of patients from acute to stable period showed a obvious positive correlation with the improvement of CAT score and FENO,the improvement of CAT score showed a obvious positive correlation with the improvement of FENO（P 〈0. 05）. Conclusion FeNO may comparatively easily and quickly reflect the airway inflammation and quality of Life in patients have COPD,the higher FeNO level and CAT score,the lower quality of life and disease controlling of COPD. FENO combine lung unction and CAT score reflect the quality of life and disease controlling of COPD more totally