实用医学杂志 ›› 2021, Vol. 37 ›› Issue (9): 1145-1149.doi: 10.3969/j.issn.1006⁃5725.2021.09.010

• 临床研究 • 上一篇    下一篇

气道不同部位一氧化氮测定在慢性阻塞性肺疾病中的价值

吴敏, 金蒙蒙, 赵磊    

  1. 安徽医科大学第四附属医院呼吸与危重症医学科(合肥 230061)

  • 出版日期:2021-05-10 发布日期:2021-05-10
  • 通讯作者: 赵磊 E⁃mail:leizhao1973@163.com
  • 基金资助:

    安徽高校省级自然科学研究重点项目(编号: KJ2019A0269);安徽医科大学校科研基金项目(编号:2018xkj059)

The value of exhaled nitric oxide in different parts of the airway in chronic obstructive pulmonary dis⁃ ease 

WU min,JIN Mengmeng,ZHAO Lei.    

  1. Department of Respiratory and Critical Care Medicine,the Fouth Affili⁃ ated Hospital of Anhui Medical University,Hefei 230061,China 

  • Online:2021-05-10 Published:2021-05-10
  • Contact: ZHAO Lei E⁃mail:leizhao1973@163.com

摘要:

目的 探讨气道不同部位呼出气一氧化氮(FeNO)检测在慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)中的应用价值。方法 选取从 2019 1 月至 2020 5 月就诊我院的 COPD 患者82例进行观察研究。其中COPD 稳定期患者37例,COPD 急性加重期患者45例,并选取20例健康体检者作为对照组。测定各组呼出气一氧化氮(NO)浓度,记录中心大气道 NO 浓度(FeNO50)及肺泡 NO 浓度(CaNO)。同时收集肺功能,血白细胞(WBC),嗜酸性粒细胞百分比(EOS%),C 反应蛋白(CRP CAT 评分等临床变量作为观察指标。结果 COPD 急性加重组 CaNO、CRP、WBC 明显高于 COPD 稳定 组及对照组,差异有统计学意义(P < 0.05)。在 COPD 急性加重组,CaNO CAT 评分呈正相关(r = 0.627 P < 0.001),与 FEV1%呈负相关(r = -0.457,P = 0.002),而 FeNO50 CAT 评分及 FEV1%无相关性。分层分析发现 CaNO CAT 评分> 20 分及 FEV1% < 50%组中明显升高(P < 0.05),而 FeNO50在两组中差异无统计学意义(P > 0.05)。结论 COPD 患者气道不同部位 NO 浓度存在差异,CaNO 可能是反映 COPD 患者远端小气道炎症更好的生物学指标,可用于监测COPD 急性加重期间的炎症活动。

关键词:

呼出气一氧化氮, 慢性阻塞性肺疾病, 气道炎症, CaNO

Abstract:

Objective To investigate the value of detecting fractional exhaled nitric oxide(FeNO)in different parts of the airway in chronic obstructive pulmonary disease(COPD).Methods A total of 82 COPD patients admitted to our hospital from January 2019 to May 2020 were selected for an observational study. Among them,37 patients with stable COPD and 45 patients with acute exacerbation of COPD were selected,while 20 healthy subjects were selected as the control group. The exhaled nitric oxide(NO)concentration in each group was determined,and the concentration of NO in central airway(FeNO50)and alveolar NO(CaNO)were recorded. Clinical variables such as lung function,white blood cell count(WBC),eosinophil percentage(EOS%),C⁃reactive protein (CRP and CAT score were collected as the observation indexes.Results CaNO ,CRP and WBC in acute exacerbation of COPD were significantly higher than those in COPD stable group and control group ,and the difference was statistically significant(P < 0.05). There was a significant positive correlation between CaNO and CAT score(r = 0.627,P < 0.001)and a significant negative correlation between CaNO and FEV1%(r = -0.457 P = 0.002)in COPD with acute exacerbation,while FeNO50 was not significantly correlated with CAT score and FEV1%. Stratified analysis showed that CaNO was significantly increased in CAT score > 20 and FEV1% < 50% groups(P < 0.05),but there was no difference in FeNO50 between the two groups(P > 0.05). Conclusion The concentration of NO in different parts of the airway was different in COPD patients.CaNO may be a better biological indicator of small airway inflammation in patients with COPD and can be used to monitor inflammatory activity during acute exacerbation of COPD. 

Key words:

fractional exhaled nitric oxide, chronic obstructive pulmonary disease, airway inflamma? tion, alveolar nitric oxide