呼出气一氧化氮测定在过敏因素所致慢性咳嗽诊疗中的应用价值

Value of exhaled nitric oxide in the diagnosis and treatment of chronic cough caused by allergic factors

目的探讨呼出气一氧化氮(FeNO)测定应用于过敏因素所致慢性咳嗽诊疗中的价值。方法选取2017年1月至2018年8月在山西晋煤集团总医院进行治疗的78例过敏因素所致慢性咳嗽患者,对其进行FeNO检测,并根据检测结果将其分为低水平组(FeNO<25ppb)、中水平组(FeNO为25~50ppb)及高水平组(FeNO>50ppb),并根据患者是否伴有感染等症状将中水平组细分为中水平A组及中水平B组。全部患者均采用醋酸泼尼松片进行治疗,比较四组患者治疗前及治疗1周后咳嗽症状积分及FeNO水平。治疗1周后,对症状显著改善患者进行丙酸倍氯米松吸入气雾剂治疗3周,比较其治疗1周及治疗4周后患者咳嗽症状积分及FeNO水平。结果治疗1周后,中水平B组及高水平组患者咳嗽症状积分及FeNO水平与治疗前比较差异有统计学意义(P<0.05),而低水平组及中水平A组治疗前后咳嗽症状积分及FeNO水平比较差异未见统计学意义(P>0.05)。中水平B组及高水平组患者治疗4周后,其咳嗽症状积分及FeNO水平与治疗1周时比较,差异均有统计学意义(P<0.05)。结论采用呼出气一氧化氮检测方法,能够对过敏因素所致慢性咳嗽进行检测,其检测价值较高,且能够为患者治疗的合理性提高科学依据,值得推广。

Objective To investigate the value of exhaled nitric oxide (FeNO) in the diagnosis and treatment of chronic cough caused by allergic factors. Methods A total of 78 patients with chronic cough caused by allergic factors treated in General Hospital of Shanxi Jincheng Coal Group from January 2017 to August 2018 were selected. FeNO was detected and classified into low level group (FeNO<25 ppb), medium-level group (FeNO 25-50 ppb) and high-level group (FeNO>50 ppb), and the middle-level group was subdivided into middle-level B group and middle level A group according to whether the patient was accompanied by infection and other symptoms. All patients were treated with prednisone acetate tablets. The cough symptom scores and FeNO levels before treatment and 1 week after treatment were compared among the four groups. After 1 week of treatment, beclomethasone propionate inhalation aerosol was given to patients whose symptoms were improved remarkably for 3 weeks. And then, cough symptom scores and FeNO levels were compared between these patients after 1 week and 4 weeks of treatment. Results After 1 week of treatment, the scores of cough symptoms and FeNO levels in the middle-level B group and the high-level group were significantly different from those before treatment (P<0.05). Howevre, there was no significant difference in cough symptom score and FeNO level between low-level group and middle-level group A after treatment (P> 0.05). After 4 weeks of treatment, the scores of cough symptoms and the levels of FeNO in the middle and high level B groups were different from those in the first week after treatment (P<0.05). Conclusions Exhaled nitric oxide detection method can detect chronic cough caused by allergic factors. It has high detection value and can improve the scientific basis for the rationality of treatment. It is worth popularizing.