口呼一氧化氮对评估哮喘气道炎症的价值

Study on NO level in exhaled air as a marker of the respiratory truct inflammation in patients with asthma

目的 研究哮喘患者口呼一氧化氮 (NO)平均体积分数的变化 ,探讨其临床意义。方法 用化学发光法检测2 5例哮喘患者 (急性发作期 13例 ,缓解期 12例 ;其中有 7例为可疑职业性哮喘 )、2 6例不吸烟健康者、2 4例无症状吸烟者和 2 0例慢性阻塞性肺疾病 (COPD)患者 (其中急性加重期 11例 ,稳定期 9例 )的口呼NO平均体积分数和鼻呼NO平均体积分数。结果 哮喘患者口呼NO平均体积分数为 ( 2 8 9± 6 6)× 10 -9,高于不吸烟健康组 ( 15 0± 5 2 )× 10 -9和无症状吸烟组 ( 7 3± 4 5 )× 10 -9(P <0 0 1)。哮喘急性发作期和缓解期口呼NO平均体积分数分别为 :( 2 9 4± 5 8)× 10 -9和( 2 8 4± 7 5 )× 10 -9,两者比较差异无显著性 (P >0 0 5 )。 7例可疑职业性哮喘患者口呼NO平均体积分数亦增高 ,但是与其他哮喘比较差异无显著性 [( 30 9± 7 0 )× 10 -9,( 2 8 1± 6 4)× 10 -9,P >0 0 5 ]。鼻呼NO平均体积分数各组之间比较差异无显著性 (P >0 0 5 )。结论 哮喘患者口呼NO平均体积分数增高 。

Objective To investigate the variety of mean NO level in exhaled air,and found out its clinical significance.Method Exhaled NO measurements were performed using a chemiluminescence.Ninety-five subjects were entered into this study,these subjects included25subjects with asthma(13subjects were in acute exacerbation phase,12subjects were in remission phase),seven of themwere suspected occupational asthma(4subjects were in exacerbation phase,3subjects were in remission phase),26nonsmok-ing control subjects,24asymptomatic smokers,and20subjects with chronic obstructive pulmonary disease(COPD)(11subject were in acute exacerbation phase,9subjects were in remission phase).Result Exhaled NO level between subjects with asthma(28.9±6.6)×10 -9 and nonsmoking control subjects(15.0±5.2)×10 -9 or asymptomatic smokers(7.3±4.5)×10 -9 were significant different(P<0.01).Also,the mean oral exhaled NO level in7cases of suspected occupational asthma were significant increased,but no quantitative difference between the non-occupational asthma and suspected occupational asthma〔(28.1±6.4)×10 -9 ,(30.9±7.0)×10 -9 ,P>0.05〕.However,there was no difference between the subgroups of asthma〔(29.4±5.8)×10 -9 ,(28.4±7.5)×10 -9 ,P>0.05〕.The result also suggested that there was no difference between the subgroups of mean nasal exhaled NO level.Conclusion The mean oral exhaled NO level in patients with asthma increased,and it can be used as a clinical marker for moni-toring the inflammation of the airway for asthmatic patients.