FeNO和外周血EOS%对支气管扩张合并哮喘的诊断价值

Value of Fe NO and EOS% in diagnosis of bronchiectasis with airway obstruction and asthma

目的:探讨呼出气一氧化氮(FeNO)、外周血嗜酸性粒细胞百分比(EOS%)在支气管扩张伴气道阻塞合并哮喘患者中的诊断价值。方法:收集2016—2017年住院的88例肺部高分辨CT诊断为支气管扩张的患者,进行肺功能检查后将支气管扩张伴气道阻塞合并哮喘患者28例设为A组,支气管扩张伴气道阻塞未合并哮喘患者26例设为B组,支气管扩张不伴气道阻塞患者34例设为C组,20例体检者设为对照组(D组),比较各组FeNO水平、外周血EOS%及临床表现。结果:(1)A组FeNO水平、外周血EOS%高于B组及C组(P<0.05);(2)A组个人过敏史和肺部闻及哮鸣音率高于B组(64.30%vs 9.20%,82.10%vs 38.50%)(P<0.05)。结论:支气管扩张伴气道阻塞合并哮喘患者较未合并哮喘患者FeNO、外周血EOS%水平明显偏高,且更易表现为个人过敏史、双肺更易闻及哮鸣音。FeNO、外周血EOS%对支气管扩张伴气道阻塞合并哮喘的辅助诊断可能有重要的参考价值。

Objective： To investigate the value of fractional exhaled nitric oxide（FeNO） and percentage of eosinophils in peripheral blood（EOS%） in the diagnosis of bronchiectasis with airway obstruction associated with asthma. Methods： From 2016 to 2017,88 hospitalized patients diagnosed as bronchiectasis by lung high-resolution CT received pulmonary functions examination.And then they were divided into group A（bronchiectasis with airway obstruction and asthma,28 cases）,group B（bronchiectasis with airway obstruction and without asthma,26 cases）,and group C（bronchiectasis without airway obstruction,34 cases）; 20 healthy people were selected as control group（group D）. The FeNO levels,EOS% and clinical manifestations were compared among the four groups. Results：（1） The FeNO level and EOS% of group A were significantly higher than those of group B and group C（P〈0. 05）.（2） Group A had significantly higher rates of a history of individual allergies and pulmonary wheezing rales than group B（64. 30% vs 9. 20%,82. 10% vs 38. 50%）（P〈0. 05）. Conclusion： FeNO level and EOS% are evidently high in bronchiectasic patients with airway obstruction and asthma compared with those without asthma. Moreover,they are more likely to have a history of individual allergies and wheezing rales are more likely to be heard in both lungs. FeNO and EOS% may be of important value in the diagnosis of bonchiectasis with airway obstruction and asthma.