呼出气一氧化氮水平与血液嗜酸性粒细胞计数在鉴别慢性阻塞性肺疾病重叠支气管哮喘中的作用

Significance of the fractional exhaled nitric oxide level and blood eosinophil count in differentiating asthmachronic obstructive pulmonary overlapping disease from chronic obstructive pulmonary disease

目的:探讨呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)和血液嗜酸性粒细胞在慢性阻塞性肺疾病(chronic obstructive pulmoriary disease,COPD)和支气管哮喘-COPD重叠(asthma-COPD overlap,ACO)中的诊断价值。方法:纳入2016年1月至2019年1月在我院接受FeNO和嗜酸性粒细胞计数检测的气道炎症患者178例,分为单独COPD组和ACO组,对其一般情况、FeNO和嗜酸性粒细胞进行统计分析。结果:COPD组和ACO组受试者年龄、性别、体质量指数等差异无统计学意义(均P>0.05);COPD组患者FeNO低于ACO组(P=0.001 2)。ACO组嗜酸性粒细胞计数高于COPD组(P=0.014 1)。但COPD组患者的FeNO水平与嗜酸性粒细胞计数之间无相关性(r=0.698,P=0.525),ACO组患者的FeNO水平与嗜酸性粒细胞计数之间存在相关性(r=0.649,P=0.042)。结论:FeNO水平与嗜酸性粒细胞计数对于ACO和COPD之间的鉴别诊断具有一定的意义。

Objective To investigate the value of the fractional exhaled nitric oxide(FeNO) and blood eosinophilic granulocyte count in differentiating the chronic obstructive pulmonary disease(COPD) from asthma-COPD overlapping(ACO) disease. Methods A total of 178 patients from January 2016 to January 2019 in our hospital were divided into the COPD group and the ACO group, which were based on the standard diagnosis of Global Initiative for COPD(GOLD) and the standard published by the Spanish Society of Pulmonology and Thoracic Surgery. The FeNO and eosinophil count were measured in patients with airway inflammation and the collected data was analyzed. Results There was no significant difference in age, gender and body mass index between the COPD group and the ACO group(P>0.05). The FeNO value of COPD group was lower than that of ACO group(P=0.001 2). The eosinophil count in ACO group was higher than that in COPD group(P=0.014 1). There was no correlation between the level of FeNO and eosinophil count in COPD group( r=0.698, P=0.525), while there was a correlation between the level of FeNO and eosinophil count in ACO group( r=0.649, P=0.042). Conclusions The level of FeNO and the eosinophil count in blood showed the reference value in differential diag-nosis between ACO and COPD.