大小气道呼出气一氧化氮联合肺功能检测对哮喘慢阻肺重叠早期诊断的临床意义

Clinical significance of fractional exhaled nitric oxide from large and small airways combined with pulmonary function for early diagnosis in asthma-COPD overlap

目的探讨大小气道呼出气一氧化氮(FeNO_(50)和FeNO_(200))联合肺功能检测在哮喘慢阻肺重叠(ACO)早期诊断中的临床意义。方法纳入ACO患者、慢性阻塞性肺疾病(COPD)患者及同期健康体检者各60例设为ACO组、COPD组和对照组,比较3组受试者FeNO_(50)、FeNO_(200)、外周血嗜酸性粒细胞百分比(EOS%)及肺功能指标的差异。结果ACO组FeNO_(50)、FeNO_(200)和EOS%高于COPD组和对照组,COPD组FeNO_(200)高于对照组(P<0.05)。ACO组和COPD组FEV1%pred及FEV1/FVC%低于对照组,RV/TLC%高于对照组(P<0.05)。ACO组和COPD组MMEF%pred及DLCO%pred低于对照组,ACO组MMEF%pred及DLCO%pred低于COPD组(P<0.05)。结论FeNO_(50)和FeNO_(200)双重检测可全面评估ACO患者的大小气道嗜酸性粒细胞炎症水平,两者联合肺功能检测对ACO的早期诊断具有重要的参考价值。

Objective To investigate the clinical significance of fractional exhaled nitric oxide(FeNO)from small and large airways(labed as FeNO_(50)and FeNO_(200))combined with pulmonary function for early diagnosis in patients with asthma-COPD overlap(ACO).Methods The patients with ACO,COPD and healthy examinees were selected randomly as ACO group,COPD group and Control group(n=60,respectively).FeNO_(50),FeNO_(200),percentage of peripheral blood eosinophils(EOS%),lung function parameters and their clinical significance were compared among the three groups.Results FeNO_(50),FeNO_(200)and EOS%in ACO group were higher than those in COPD group and Control group,FeNO_(200)in COPD group was higher than that in Control group(P<0.05).FEVl%pred and FEV1/FVC%in ACO group and COPD group were lower than those in Control group,RV/TLC%in ACO group and COPD group were higher than those in Control group(P<0.05).MMEF%pred and DLco%pred in ACO group and COPD group were significantly lower than those in Control group,MMEF%pred and DLco%pred in ACO group were lower than those in COPD group(P<0.05).Conclusion The dual test of FeNO_(50)and FeNO200 can comprehensively assess the levels of eosinophils inflammation in large and small airways with ACO patients,which combined with pulmonary function have important reference value for early diagnosis of ACO.