痰嗜酸性粒细胞计数与呼出气一氧化氮浓度在慢性阻塞性肺疾病中的应用

Application of sputum eosnophils cell counts and fraction of nitric oxide in exhaled air in chronic obstructive pulmonary disease

目的:探讨诱导痰嗜酸性粒细胞计数(EOS)与呼出气一氧化氮浓度(Fe NO)在慢性阻塞性肺疾病(COPD)中的应用。方法:选择COPD患者48例,对所有患者均进行诱导痰细胞分类及计数,EOS≥3%者为A组,EOS<3%者为B组。两组患者均给予布地奈德吸入剂,每次200μg,每日2次,连用8周。记录治疗前后各组的EOS、Fe NO及第1秒用力呼气容积占预计值百分比(FEV1%pre)。结果:治疗前A组Fe NO比B组高,差异有统计学意义(P<0.05)。A组治疗后EOS和Fe NO比治疗前下降,FEV1%pre比治疗前升高(P<0.05)。B组治疗前后EOS、Fe NO、FEV1%pre比较,差异均无统计学意义(P>0.05)。结论:诱导痰EOS升高的COPD患者的Fe NO升高,吸入糖皮质激素可有效控制气道炎症,改善肺功能;但对诱导痰EOS不高的COPD患者则无明显疗效。

Objective：To investigate the application of eosnophils（EOS） cell counts in induced sputum and fraction of nitric oxide in exhaled air（FeNO） in chronic obstructive pulmonary disease（COPD）.Methods：A total of 48 patients with COPD were studied,all patients were inhaled hypertonic saline and were examined EOS cell counts in induced sputum.All of the patients were divided into group A with EOS cell counts≥3% and group B with EOS cell counts〈3%.All patients were given budesonide inhaler 200 μg twice a day for 8 weeks.We examined EOS,FeNO and forced expiratory volume in one second as percentage of predicted volume（FEV1%pre） of all patients both before and after treatment.Results：FeNO in group A was higher than in group B before treatment（ P 〈0.05）.Both EOS and FeNO were decreased after treatment in group A（ P 〈0.05）,while FEV1%pre was increased（ P 〈0.05）.In group B,there were not significant changes in EOS,FeNO and FEV 1% pre between after treatment and before （ P 〉0.05）.Conclusion：There was a higher level of FeNO in patients of COPD with EOS cell counts in induced sputum≥3% than those with EOS cell counts in induced sputum〈3%.After treatment of inhaled corticosteroids,airway inflamation was reduceded and lung function improved in patients of COPD with EOS in induced sputum≥3%,but there was not obvious effect in patients of COPD with EOS in induced sputum〈3%.