呼出气一氧化氮检测在哮喘慢阻肺重叠综合征的诊疗价值

The value of fractional exhaled nitric oxide detection in the diagnosis and treatment of asthma-COPD overlap syndrome

目的探究呼出气一氧化氮(FENO)检测在哮喘慢阻肺重叠综合征中的诊疗价值。方法选取本院2017年2月—2019年1月期间收治的30例哮喘慢阻肺重叠综合征患者作为观察组,选择同期在本院进行健康检查的30例非哮喘慢阻肺重叠综合征患者作为对照组,对照组静脉滴注生理盐水,观察组静脉滴注糖皮质激素,分别在治疗前后测定FENO、1 s用力呼气容积预计值(FEV1%)、血嗜酸性粒细胞(EOS)、超敏C反应蛋白(hs-CRP),比较两组治疗前后上述各指标水平,分析哮喘慢阻肺重叠综合征患者FENO与FEV1%、EOS、hs-CRP的相关性。结果对照组治疗前后FENO、FEV1%、EOS、hs-CRP相比,差异无统计学意义(P>0.05);观察组治疗后FENO、EOS、hs-CRP低于治疗前,但治疗前后FENO均高于对照组,差异有统计学意义(P<0.05);观察组治疗后FEV1%高于治疗前,但治疗前后FEV1%均低于对照组,差异有统计学意义(P<0.05)。治疗前,观察组FENO与FEV1%无相关性(r<0,P>0.05);FENO与EOS、hs-CRP呈正相关性(r>0,P<0.05);治疗后,FENO与FEV1%无相关性(r<0,P>0.05);FENO与EOS、hs-CRP呈正相关性(r>0,P<0.05)。结论哮喘慢阻肺重叠综合征患者体内FENO高于正常人群,且FENO与EOS、hs-CRP具有显著的相关性,可作为评估该疾病疗效的重要指标。

Objective To investigate the value of fractional exhaled nitric oxide(FENO)detection in the diagnosis and treatment of asthma-COPD overlap syndrome(ACOS).Methods 30 patients with ACOS who admitted in the hospital from February 2017 to January 2019 were selected as observation group,and 30 cases of non-ACOS patients with physical examination in the hospital were selected as control group.Control group was given intravenous drip of saline,and observation group was treated with intravenous drip of glucocorticoids.The FENO,predicted value of forced expiratory volume in one second(FEV1%),eosnophils(EOS),high-sensitivity C-reactive protein(hs-CRP)were detected before and after treatment.The levels of the above-mentioned indexes before and after treatment were compared between the two groups.The correlation between FENO and FEV1%,EOS,hs-CRP in patients with ACOS was analyzed.Results There was no statistical difference in the FENO,FEV1%,EOS,hs-CRP in control group before and after treatment(P>0.05);After treatment,the FENO,EOS and hs-CRP in observation group were lower than those before treatment,but the FENO of observation group was higher than that of control group before and after treatment,and the difference was statistically significant(P<0.05);The FEV1%of observation group after treatment was higher than that before treatment,but the FEV1%in observation group was lower than that in control group before and after treatment,and the difference was statistically significant(P<0.05);Before treatment,there was no correlation between FENO and FEV1%in observation group(r<0,P>0.05);The FENO was positively correlated with EOS and hs-CRP(r>0,P<0.05);After treatment,there was no correlation between FENO and FEV1%(r<0,P>0.05);The FENO was positively correlated with EOS and hs-CRP(r>0,P<0.05).Conclusion The FENO of ACOS patients is higher than that of normal people,and FENO is significantly correlated with EOS and hs-CRP,which can be used as an important index to evaluate the efficacy of the disease.