呼出气一氧化氮及血清髓过氧化物酶测定在重症哮喘表型识别中的应用

Application value of fractional exhaled nitric oxide and myeloperoxidase in phenotypic recognition of severe asthma

目的:探讨呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)和血清髓过氧化物酶(myeloperoxidase,MPO)测定在重症哮喘表型识别中的应用。方法:选取稳定期支气管哮喘病人40例(重症哮喘20例,非重症哮喘20例)作为研究对象,并选择同期体检的20名健康人员作为对照组。采用酶联免疫吸附法测定血清MPO水平,使用FeNO检测仪检测FeNO水平,同时测定血常规(中性粒细胞及嗜酸粒细胞计数)和IgE水平。比较各组FeNO、血清MPO、中性粒细胞、嗜酸粒细胞和IgE水平。结果:对照组、非重症哮喘组、重症哮喘组血清MPO水平差异有统计学意义(P<0.01);重症哮喘组血清MPO水平明显高于对照组和非重症哮喘组(P<0.01)。各组外周血中性粒细胞水平差异无统计学意义(P>0.05)。各组FeNO、IgE水平差异均有统计学意义(P<0.01);重症哮喘组FeNO水平明显高于对照组和非重症哮喘组(P<0.01);非重症哮喘组、重症哮喘组IgE水平高于对照组(P<0.05和P<0.01)。各组嗜酸粒细胞水平差异无统计学意义(P>0.05)。结论:重症哮喘病人存在血清MPO和FeNO水平的升高,通过检测血清MPO、FeNO水平有助于识别重症支气管哮喘病人表型,对重症哮喘的个体化治疗具有重要指导意义。

Objective:To explore the application value of the detection of serum myeloperoxidase(MPO)and fractional exhaled nitric oxide(FeNO)in severe asthma phenotyping.Methods:Forty patients with stable bronchial asthma included 20 cases with severe asthma and 20 cases with non-severe asthma.Twenty cases with severe asthma,20 cases with non-severe asthma and 20 healthy people were divided into the severe asthma group,non-severe asthma group and control group,respectively.The serum level of MPO was detected using enzyme-linked immunosorbent assay,and the FeNO level was detected using FeNO detector.The neutrophilic granulocyte count,eosinophile granulocyte count and IgE level in the peripheral blood were also detected.The levels of serum MPO,FeNO,neutrophilic granulocyte,eosinophile granulocyte and IgE among three groups were compared.Results:The differences of the serum MPO level among three groups were statistically significant(P<0.01),and the serum MPO level in severe asthma group was significantly higher than that in control group and non-severe asthma group(P<0.01).The difference of the neutrophil level in peripheral blood among three groups was not statistically significant(P>0.05).The differences of the levels of FeNO and IgE among three groups were statistically significant(P<0.01),the FeNO level in severe asthma group was significantly higher than that in control group and non-severe asthma group(P<0.01),and the levels of IgE in non-severe asthma group and severe asthma group were higher than that in control group(P<0.05 and P<0.01).There was no statistical significance in the eosinophil level among three groups(P>0.05).Conclusions:The serum levels of MPO and FeNO in severe asthma patients increase.The detection of serum MPO and FeNO level is helpful to identify phenotypes in patients with severe bronchial asthma,which has great significance in the individualized treatment of disease.