文章摘要
呼出气一氧化氮测定在COPD频繁急性加重表型患者中的临床意义
The clinical significance of exhaled nitric oxide measurement in patients with frequent acute exacerbation of chronic obstructive pulmonary disease
投稿时间:2022-02-16  
DOI:10.3969/j.issn.1000-0399.2022.12.006
中文关键词: 一氧化氮  慢性阻塞性肺病  频繁急性加重表型  外周气道呼出气一氧化氮  肺泡气一氧化氮
英文关键词: Nitric oxide  Chronic obstructive pulmonary disease  Frequent acute exacerbation phenotype  The peripheral airway exhales nitric oxide  Alveolar nitric oxide
基金项目:安徽省高校自然科学基金项目(项目编号:2019xky061)
作者单位E-mail
林明珍 230061 安徽合肥 安徽医科大学第四附属医院呼吸与危重症医学科  
金蒙蒙 230061 安徽合肥 安徽医科大学第四附属医院呼吸与危重症医学科  
曹晓慧 230061 安徽合肥 安徽医科大学第四附属医院呼吸与危重症医学科 794518657@qq.com 
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中文摘要:
      目的 探讨中央和外周气道呼出气一氧化氮(FeNO)在慢性阻塞性肺病(COPD)频繁急性加重表型患者中的临床意义。方法 收集2019年1月至2021年6月安徽医科大学第四附属医院呼吸与危重症医学科收治的90例COPD患者作为研究对象,在一年内因急性加重次数≥2次的患者纳入频繁急性加重组(n=23),急性加重次数≤1次的患者纳入非频繁急性加重组(n=67)。测定两组中央气道一氧化氮(FeNO50)浓度和外周气道呼出气一氧化氮(FeNO200)浓度、肺泡气一氧化氮(CaNO)浓度并收集白细胞计数、血嗜酸粒细胞百分比、血清总免疫球蛋白E(IgE)、慢性阻塞性肺疾病评估测试(CAT)评分及肺功能等相关指标,对进行对比分析。结果 COPD频繁急性加重组FeNO200、CaNO、C反应蛋白(CRP)、血清总IgE、CAT评分均高于非频繁急性加重组,第一秒用力呼气容积占预计值百分比(FEV1%)低于非频繁急性加重组(P<0.05)。在COPD急性加重患者中,FeNO200、CaNO与FEV1%呈负相关(r=-0.305、-0.439,P<0.05),与血清总IgE呈正相关(r=0.523、0.514,P<0.05),其中CaNO还与CRP呈正相关(r=0.321,P=0.023)。结论 COPD频繁急性加重表型患者中央和外周FeNO浓度存在差异,FeNO200、CaNO均可作为COPD患者外周小气道炎症指标。
英文摘要:
      Objective To investigate the clinical value of central and peripheral exhaled nitric oxide detection in patients with COPD with frequent acute exacerbations. Methods A total of 90 COPD patients admitted to the Department of Respiratory and Critical Care Medicine of the Fourth Affiliated Hospital of Anhui Medical University from January 2019 to June 2021 were selected as the study subjects.We enrolled the patients of frequent exacerbations as two or more exacerbations in a year in frequent exacerbations group (n=23), and enrolled the patients of infrequent exacerbations as less than two exacerbations in a year in infrequent exacerbations group (n=67). The concentration of central airway nitric oxide (FeNO50), peripheral airway exhaled nitric oxide (FeNO200) and alveolar nitric oxide (CaNO) were measured in the two groups. White blood cell (WBC) count, blood eosinophil percentage (EOS%), serum total IgE, Chronic Obstructive Pulmonary Disease Assessment Test (CAT) score, lung function and other related indicators were collected. The above indexes were compared and analyzed. Results COPD frequent acute recombination and FeNO200, CaNO, CRP, serum total IgE, CAT score were significantly higher than infrequent acute recombination. The percentage of forced expiratory volume in the first second to the expected value (FEV1%)was significantly lower than infrequent acute recombination (P<0.05). FeNO200 and CaNO were negatively correlated with FEV1% in patients with acute exacerbation of COPD (r=-0.305, -0.439, P<0.05), was positively correlated with serum total IgE (r=0.523, 0.514, P<0.05), and CaNO was positively correlated with CRP (r=0.321, P=0.023). Conclusions There are differences in central and peripheral exhated nitric oxide between patients with COPD frequent acute exacerbation phenotype. FeNO200 and CaNO can both be used as indicators of peripheral small airway inflammation.
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