哮喘慢阻肺重叠综合征患者FeNO水平变化及其与炎症因子、肺功能的相关性研究

Changes of FeNO level in patients with asthma-chronic obstructive pulmonary disease overlap syndrome and its correlation with inflammatory factors and pulmonary function

目的:探究哮喘慢阻肺重叠综合征(ACOS)患者呼出气一氧化氮(FeNO)水平变化与炎症因子、肺功能的相关性。方法:64例ACOS患者设为ACOS组,70例慢性阻塞性肺疾病(COPD)患者设为COPD组,66例支气管哮喘(BA)患者设为BA组,40名同期健康体检者设为对照组。检测并对比各组FeNO、炎症因子[C反应蛋白(CRP)、降钙素原(PCT)]、肺功能[第1秒用力呼气容积占预计值百分比(FEV_(1)%_(pred))、第1秒用力呼气容积/用力肺活量(FEV_(1)%_(pred))]水平。结果:与对照组相比,ACOS组、COPD组、BA组的FeNO、CRP、PCT水平均升高(P<0.05),FEV_(1)%_(pred)、FEV_(1)/FVC水平降低(P<0.05);且ACOS组、COPD组、BA组的血清CRP、PCT水平依次降低,COPD组、ACOS组、BA组的FeNO、FEV_(1)%_(pred)、FEV_(1)/FVC水平依次升高(P<0.05)。Pearson相关性分析显示,ACOS组、COPD组、BA组的FeNO水平与CRP(r=0.583、0.615、0.330)、PCT(r=0.520、0.429、0.504)呈正相关(P<0.05),与FEV_(1)%_(pred)(r=-0.326、-0.211、-0.414)、FEV_(1)/FVC(r=-0.397、-0.372、-0.475)呈负相关(P<0.05)。结论:ACOS患者FeNO水平呈高表达,且与血清CRP、PCT呈正相关,与肺功能呈负相关,可作为气道炎症反应程度的指标,指导临床诊疗工作。

Objective:To investigate the correlation between fractional exhale nitric oxide(FeNO)level in patients with asthma-chronic obstructive pulmonary disease overlap syndrome(ACOS)and it’s correlation with inflammatory factors and lung function Methods:64 patients with ACOS were selected as ACOS group,70 patients with chronic obstructive pulmonary disease(COPD)were selected as COPD group,66 patients with bronchial asthma(BA)were selected as BA group,and 40 healthy were selected as control group.The levels of FeNO,inflammatory factors[C-reactive protein(CRP),procalcitonin(PCT)],pulmonary function[forced expiratory volume in 1 second(FEV1%pred),forced expiratory volume in one second/forced vital capacity(FEV_(1)/FVC)]were detected and compared.Results:Compared with the control group,the levels of FeNO,CRP and PCT in ACOS group,COPD group and BA group were increased,while the levels of FEV_(1)%_(pred)and FEV_(1)/FVC were decreased(P<0.05).The levels of serum CRP and PCT in ACOS group,COPD group and BA group decreased in turn,while the levels of FeNO,FEV_(1)%_(pred)and FEV_(1)/FVC in COPD group,ACOS group and BA group increased in turn(P<0.05).Pearson correlation analysis showed that the levels of FeNO in ACOS group,COPD group and BA group were positively correlated with CRP(r=0.583,0.615,0.330)and PCT(r=0.520,0.429,0.504,P<0.05),and negatively correlated with FEV_(1)%_(pred)(r=0.326,0.211,0.414)and FEV_(1)/FVC(r=0.397,0.372,0.475,P<0.05).Conclusion:FeNO levels in patients with ACOS increased,and are positively correlated with serum CRP and PCT,and negatively correlated with lung function.It can be used as an indicator of airway inflammation in patients with ACOS to guide clinical diagnosis and treatment.