呼出气一氧化氮检测在哮喘—慢阻肺重叠综合征诊疗中的临床意义(1)
【摘要】 目的：探讨呼出气一氧化氮(FeNO)检测对哮喘-慢性阻塞性肺疾病重叠综合征(ACOS)的诊疗意义。方法：选取2015年11月-2016年5月就诊于本院呼吸科的ACOS、哮喘、COPD患者及健康对照组146例为研究对象，ACOS组24例，哮喘组40例，COPD组52例，对照组30例。分析四组间FeNO、FEV1%预计值(FEV1%pred)、第一秒最大呼气量/用力肺活量(FEV1/FVC)的差异，FeNO与肺功能的相关性，肺功能GOLDⅠ～Ⅳ级间FeNO值的差异。结果：ACOS组与哮喘组FeNO水平显著高于COPD组与对照组，差异均有统计学意义(P<0.05).ACOS与哮喘组间、COPD与对照组间FENO水平比较，差异均无统计学意义(P>0.05)。COPD组与ACOS组的FEV1、FEV1%pred、FVC、FVC%pred、FEV1/FVC均显著低于哮喘组与对照组，ACOS组的FEV1%预计值低于COPD组，差异均有统计学意义(P<0.05)。COPD组与ACOS组年龄及FeNO分布在GOLD不同肺功能组间比较，差异均无统计学意义(P>0.05)。FeNO值与肺通气功能各指标之间无线性相关。结论：FeNO检测能有效判断ACOS患者的气道炎症水平，与肺通气功能联合应用有助于ACOS与其他慢性阻塞性气道疾病的鉴别诊断。
【关键词】 支气管哮喘； 哮喘-慢阻肺重叠综合征； 呼出气一氧化氮
【Abstract】 Objective：To explore the clinical significance of fractional exhaled nitric oxide(FeNO)in diagnosis and treatment of asthma-COPD overlap syndrome(ACOS).Method：A total of 146 cases in our hospital from November 2015 to May 2016 were selected as the objects of study，24 cases in ACOS group，40 cases in asthma group，52 cases in COPD group and 30 cases in control group.The differences in FeNO，FEV1%pred and FEV1/FVC among four groups was analyzed，and the relevance of FeNO to FEV1%pred and FEV1/FVC was detect.Result：The value of FeNO in ACOS group and asthma group were higher than that in COPD group and the control group，the differences were statistically significant(P<0.05).There were no statistically significant in the value of FeNO between ACOS group and COPD group，asthma group and control group(P>0.05).The values of FEV1，FEV1%pred，FVC，FVC%pred and FEV1/FVC in ACOS group and COPD group were lower than those in asthma group and control groups，the value of FEV1%pred in ACOS group was lower than that in COPD group，the differences were statistically significant(P<0.05).There were no statistically significant in FeNO and age of ACOS group and COPD group in GOLD classification(P>0.05).There were no correlation in FeNO and pulmonary ventilation function indexs(P>0.05).Conclusion：The detection of FeNO can effectively estimate the levels of airway inflammation in ACOS patients，it combined with pulmonary ventilation function can help diagnose ACOS and COPD.
【Key words】 Asthma； Asthma-COPD overlap syndrome； Fractional exhaled nitric oxide
First-author’s address：Shenzhen Second People’s Hospital，Shenzhen 518035，China
doi：10.3969/j.issn.1674-4985.2018.15.013
支氣管哮喘和慢性阻塞性肺疾病(COPD)是临床上常见的气道阻塞性疾病，部分患者同时具有哮喘和COPD的特征，称为哮喘-慢性阻塞性肺疾病重叠综合征(ACOS)，但与哮喘和COPD相比较，ACOS的病情更重，预后更差[1-3]。本研究通过分析ACOS患者与哮喘、COPD及对照组的呼出气一氧化氮(FeNO)水平及肺通气功能的差异，旨在探讨FeNO在ACOS临床诊疗中的意义，现报道如下。, http://www.100md.com(邓海燕 王海潮)
【关键词】 支气管哮喘； 哮喘-慢阻肺重叠综合征； 呼出气一氧化氮
【Abstract】 Objective：To explore the clinical significance of fractional exhaled nitric oxide(FeNO)in diagnosis and treatment of asthma-COPD overlap syndrome(ACOS).Method：A total of 146 cases in our hospital from November 2015 to May 2016 were selected as the objects of study，24 cases in ACOS group，40 cases in asthma group，52 cases in COPD group and 30 cases in control group.The differences in FeNO，FEV1%pred and FEV1/FVC among four groups was analyzed，and the relevance of FeNO to FEV1%pred and FEV1/FVC was detect.Result：The value of FeNO in ACOS group and asthma group were higher than that in COPD group and the control group，the differences were statistically significant(P<0.05).There were no statistically significant in the value of FeNO between ACOS group and COPD group，asthma group and control group(P>0.05).The values of FEV1，FEV1%pred，FVC，FVC%pred and FEV1/FVC in ACOS group and COPD group were lower than those in asthma group and control groups，the value of FEV1%pred in ACOS group was lower than that in COPD group，the differences were statistically significant(P<0.05).There were no statistically significant in FeNO and age of ACOS group and COPD group in GOLD classification(P>0.05).There were no correlation in FeNO and pulmonary ventilation function indexs(P>0.05).Conclusion：The detection of FeNO can effectively estimate the levels of airway inflammation in ACOS patients，it combined with pulmonary ventilation function can help diagnose ACOS and COPD.
【Key words】 Asthma； Asthma-COPD overlap syndrome； Fractional exhaled nitric oxide
First-author’s address：Shenzhen Second People’s Hospital，Shenzhen 518035，China
doi：10.3969/j.issn.1674-4985.2018.15.013
支氣管哮喘和慢性阻塞性肺疾病(COPD)是临床上常见的气道阻塞性疾病，部分患者同时具有哮喘和COPD的特征，称为哮喘-慢性阻塞性肺疾病重叠综合征(ACOS)，但与哮喘和COPD相比较，ACOS的病情更重，预后更差[1-3]。本研究通过分析ACOS患者与哮喘、COPD及对照组的呼出气一氧化氮(FeNO)水平及肺通气功能的差异，旨在探讨FeNO在ACOS临床诊疗中的意义，现报道如下。, http://www.100md.com(邓海燕 王海潮)
参见：首页 > 医疗版 > 疾病专题 > 呼吸内科 > 气管、支气管疾病 > 阻塞性肺气肿