老年哮喘和慢性阻塞性肺疾病重叠患者呼出气一氧化氮水平与嗜酸性粒细胞及炎症因子的关系

The relationship of fractional exhaled nitric oxide with eosinophils and inflammatory factors in elderly patients with asthma-chronic obstructive pulmonary disease overlap syndrome

目的分析老年哮喘-慢性阻塞性肺疾病重叠(ACO)患者呼出气一氧化氮(FeNO)水平与嗜酸性粒细胞(EOS)及C-反应蛋白(CRP)、降钙素原(PCT)的相关性。方法该研究采用回顾性研究方法。按照病例入选标准,将2016年5月至2019年5月就诊于福建省老年医院的60例老年ACO患者纳入ACO组,将同期60例支气管哮喘患者纳入哮喘组,将60例慢性阻塞性肺疾病(COPD)患者纳入COPD组,将60例健康体检者纳入健康组。检测并对比4组FeNO、EOS、CRP、PCT水平,经Spearman相关性分析各组FeNO水平与EOS及炎症因子的相关性。结果单纯哮喘组FeNO水平〉ACO组〉单纯COPD组〉健康组,ACO组EOS、CRP、PCT水平〉单纯COPD组〉单纯哮喘组〉健康组(F=970.235,103.74,76.648,57.042,P均=0.000);经Spearman双变量相关性分析,单纯哮喘组FeNO水平与EOS、CRP、PCT呈正相关(r=0.646,0.326,0.497,P=0.000、0.014,0.000);单纯COPD组FeNO水平与EOS、CRP、PCT呈正相关(r=0.398,0.613,0.432,P=0.009,0.000,0.001);ACO组FeNO水平与EOS、CRP、PCT呈正相关(r=0.654,0.573,0.516,P=0.000,0.000,0.000)。结论老年ACO患者FeNO水平呈高表达,且与外周血EOS及CRP、PCT水平呈正相关,可作为气道高炎性反应的敏感指标。

Objective To analyze the relationship of fractional exhaled nitric oxide(FeNO)levels with eosinophils(EOS),C-reactive protein(CRP)procalcitonin(PCT)levels in elderly patients with asthma-chronic obstructive pulmonary disease overlap(ACO).Methods A retrospective study was conducted.According to the inclusion criteria,60 elderly patients with ACO admitted in Fujian Geriatric Hospital from May 2016 to May 2019 were enrolled in the ACO group.During the same period,60 patients with bronchial asthma were included in the asthma group,60 patients with chronic obstructive pulmonary disease(COPD)were recruited in the COPD group,and 60 people taking health examination were included in the health group.Levels of FeNO,EOS,CRP and PCT were detected and compared between the groups.Correlations of FeNO levels with EOS and inflammatory factors were analyzed by the Spearman correlation.Results The group with asthma alone showed the highest levels of FeNO,followed by the ACO group,the COPD group and the healthy group(F=970.235,P=0.000).The ACO group had the highest levels of EOS,CRP and PCT,followed by the COPD group)the asthma group and the healthy group(F=103.74,76.648 and 57.042,P=0.000).Spearman bivariate correlation analysis showed that FeNO levels were positively correlated with levels of EOS,CRP and PCT in the asthma,COPD and ACO groups(the asthma group:r=0.646,0.326 and 0.497,F=0.000,0.014 and 0.000;the COPD group:r=0.398,0.613 and 0.432,P=0.009,0.000 and 0.001 the ACO group:r=0.654,0.573 and 0.516,P=0.000,0.000 and 0.000).Conclusions High levels of FeNO are found in elderly patients with ACO.Levels of FeNO are positively correlated with EOS,CRP and PCT levels in peripheral blood,and can be used as a sensitive index for airway hyperinflammatory responses.