呼出气NO测定在AECOPD患者中的临床价值分析

Clinical value analysis of exhale nitric oxide in patients with AECOPD

目的通过测定并观察慢性阻塞性肺疾病急性加重期(acute exacrbations of chornic obstructive pulmonary disease,AECOPD)患者呼出NO(Fe NO)的变化,分析Fe NO在AECOPD患者中的临床价值。方法收集从2016年1月至2017年1月我院收治的70例AECOPD患者为急性组,选取同期门诊50例稳定期慢阻肺患者为稳定组,并选取30例健康志愿者做为健康组,分别测定三组对象的Fe NO、CRP、诱导痰嗜酸性粒细胞计数、肺功能以及CAT评分,并进行比较分析;根据Fe NO水平将急性组以27ppb为界限,分为高Fe NO患者与低Fe NO患者,高Fe NO在治疗过程中使用静脉激素治疗,低Fe NO患者在治疗过程中不使用静脉激素治疗,比较治疗前后进行CAT分值。结果三组受试者在年龄、性别、体重指数等差异无统计学意义,P>0.05;急性组与稳定组进行比较,急性组的Fe NO水平与痰嗜酸性粒细胞计数、CRP、CAT评分明显高于稳定组,差异有统计学意义,P<0.05;急性组与健康组进行比较,急性组的Fe NO水平与痰嗜酸性粒细胞计数、CRP、CAT评分明显增高,差异有统计学意义,P<0.05;稳定组与健康组进行比较,稳定组的Fe NO水平与痰嗜酸性粒细胞计数、CRP明显增高,差异有统计学意义,P<0.05。急性组治疗后CAT评分较治疗前明显升高,差异有统计学意义(P<0.05);急性组中的亚组高Fe NO患者(使用静脉激素治疗)与低Fe NO患者(未使用静脉激素治疗)在治疗后进行CAT评分组间比较,差异无统计学意义(P>0.05)。结论 Fe NO测定可有效评估AECOPD患者气道炎症的水平,无创简单,易于操作,并且在指导AECOPD患者使用糖皮质激素方面有一定参考意义。

Objective To analyze the clinical value of exhale nitric oxicde in patients witli AECOPD throughthe determination and observation the changes of exhaled NO （ FeNO） before and afte January 2016 to January 2017 ,70 AECOPD patients were selected as the acute group, and were collected as the stable group. Another 30 healthy volunteers were selected as the healthy group. Their FeNO,CRP,cell count in induced sputum, lung function and CAT score were measured and compared among the three groups. Results There was no significant difference in age,sex or BMI among the three groups （P 〉 0. 05 ） . The FeNO level and sputum eosinophil count,CRP and CAT scores in the acute group were significantly higher tlian thosein the stable group （P〈 0. 05 ）, and they were significantly higher in the acute group than in the control group （ P 〈0. 05 ）. The level of FeNOand sputum eosinophil count and CRP in the stable group were significantly higher than in the control group （ P 〈0. 05）. In the acute group,the subgroup of tlie high FeNO group and the low FeNO group hadno statistical significance in CAT scores after treatment （ P 〉0. 05）. Conclusion FeNOdetermination can effectively evaluate the airway inflammation, with the advantages of non-invasive and easy operation, which also has certain guidance in the use of glucocorticoid.