呼出气一氧化氮在布地奈德福莫特罗粉吸入剂治疗慢性咳嗽中的预测价值

Predictive value of exhaled nitric oxide in the treatment of chronic cough with budesonide and formoterol fumarate powder for inhalation

目的 观察呼出气一氧化氮(FeNO)在布地奈德福莫特罗粉吸入剂治疗慢性咳嗽中的预测价值。方法 60例接受布地奈德福莫特罗粉吸入剂治疗的慢性咳嗽患者为研究对象,将其中40例治疗有效的患者纳入观察1组,将20例治疗无效的患者纳入观察2组,再选取体检的健康者30例为对照组。对比三组受检者治疗前的FeNO水平,观察1组与观察2组患者治疗后的FeNO水平,观察1组与观察2组患者的疾病诊断结果,分析FeNO水平对治疗效果的预测效能。结果 治疗前,观察1组与观察2组患者的FeNO水平对比,差异无统计学意义(P>0.05);对照组的FeNO水平(18.71±2.35)ppb显著低于观察1组的(63.49±5.45)ppb与观察2组的(63.52±5.48)ppb,差异具有统计学意义(P<0.05)。观察2组治疗后的FeNO水平为(49.38±4.22)ppb,高于观察1组的(28.22±2.43)ppb,差异具有统计学意义(P<0.05)。观察2组患者的胃食管反流综合征患病率35.00%、上气道咳嗽综合征患病率50.00%高于观察1组的10.00%、7.50%,咳嗽变异性哮喘患病率15.00%、嗜酸性粒细胞性支气管炎患病率0低于观察1组的55.00%、27.50%,差异具有统计学意义(P<0.05)。受试者工作特征曲线(ROC曲线)分析显示,FeNO预测治疗效果的曲线下面积(AUC)为0.871,95%CI=(0.779,0.958),以33.62为最佳截断值,特异度为76.93%、敏感度为88.41%。结论 在接受布地奈德福莫特罗粉吸入剂治疗的慢性咳嗽患者治疗效果评定中FeNO水平测定具有一定的临床意义,可通过对患者FeNO水平的测定对其是否适用布地奈德福莫特罗粉吸入剂治疗做出指导。

Objective To observe the predictive value of exhaled nitric oxide(FeNO)in the treatment of chronic cough with budesonide and formoterol fumarate powder for inhalation.Methods 60 patients with chronic cough treated with budesonide and formoterol fumarate powder for inhalation were studied,of which 40 patients with effective treatment were included in observation group 1 and 20 patients with ineffective treatment included in observation group 2,and 30 healthy individuals who underwent physical examination were selected as the control group.The FeNO levels of the three groups of subjects before treatment,the FeNO levels of patients in observation group 1 and observation group 2 after treatment,and the disease diagnosis results of patients in observation group 1 and observation group 2 were compared to analyze the predictive efficacy of FeNO levels on therapeutic effects.Results Before treatment,there was no statistically statistical significance in FeNO level between observation group 1 and observation group 2(P>0.05).FeNO level of(18.71±2.35)ppb in control group was significantly lower than that of(63.49±5.45)ppb in observation group 1 and(63.52±5.48)ppb in observation group 2,and the differences were statistically significant(P<0.05).The FeNO level of observation group 2 after treatment was(49.38±4.22)ppb,which was higher than that of(28.22±2.43)ppb of observation group 1,and the difference was statistically significant(P<0.05).The prevalence of gastroesophageal reflux syndrome and upper airway cough syndrome were 35.00%and 50.00%in observation group 2,which were higher than those of 10.00%and 7.50%in observation group 1;the prevalence of cough variant asthma and eosinophilic bronchitis were 15.00%and 0 in observation group 2,which were lower than those of 55.00%and 27.50%in observation group 1;the differences were statistically significant(P<0.05).Receiver operating characteristic curve(ROC curve)analysis showed that the area under the curve(AUC)of FeNO to predict therapeutic effect was 0.871,95%CI=(0.779,0.958),with the best cut-off value of 33.62,specificity of 76.93%and sensitivity of 88.41%.Conclusion In the evaluation of the therapeutic effect of budesonide and formoterol fumarate powder for inhalation on patients with chronic cough,the determination of FeNO level has a certain clinical significance.The determination of FeNO level in patients can guide whether they are suitable for budesonide and formoterol fumarate powder for inhalation.