慢性阻塞性肺疾病患者呼出气一氧化氮水平的变化及临床意义

发布时间：2018-03-02 07:00

本文关键词： 慢性阻塞性肺疾病稳定期呼出气一氧化氮吸入性糖皮质激素肺功能　出处：《上海交通大学学报(医学版)》2017年04期 　论文类型：期刊论文

【摘要】：目的·观察慢性阻塞性肺疾病(COPD)患者接受吸入性糖皮质激素(ICS)治疗前后呼出气一氧化氮(Fe NO)水平的变化,探讨其与炎症及肺功能指标的相关性。方法·选取接受ICS治疗的稳定期COPD患者(COPD组)70例,对治疗前后的外周血嗜酸性粒细胞(Eos)和中性粒细胞(N)水平、Fe NO水平、最大呼气流量(PEF)、第1秒用力呼气容积(FEV1)及FEV1占预计值百分比(FEV1/pred)进行检测,以同期接受体检的50名健康志愿者作为正常对照(正常对照组)。分析各项指标与临床疗效的关系以及Fe NO水平与炎症及肺功能指标的相关性。结果·与正常对照组比较,COPD组治疗前外周血Eos、N水平和Fe NO水平均明显升高,PEF、FEV1、FEV1/pred明显降低(P0.05);各项指标在治疗后均明显改善(P0.05)。治疗后,显效组和好转组各项指标均明显优于无效组。相关性分析结果显示:治疗前,Fe NO水平与外周血Eos、N水平呈正相关(P0.05),与PEF、FEV1、FEV1/pred呈负相关(P0.05);治疗后,Fe NO水平与外周血Eos、N水平呈正相关(P0.05),与PEF、FEV1、FEV1/pred的相关性无统计学意义(P0.05)。结论·Fe NO水平在稳定期COPD患者中显著升高,是气道炎症的敏感指标,结合肺功能指标检查将有助于评价ICS的疗效并指导治疗。
[Abstract]:Objective: to observe the changes of nitric oxide (no) in patients with chronic obstructive pulmonary disease (COPD) before and after treatment with inhaled glucocorticoid (ICSs). Methods: 70 patients with stable COPD treated with ICS were selected to study the levels of Fe no in peripheral blood eosophils and neutrophils before and after treatment. Peak expiratory flow (PEF), forced expiratory volume (FEV1) at 1 seconds, and FEV1 as a percentage of predicted value were measured. 50 healthy volunteers who received physical examination in the same period were used as the normal control group (normal control group). The relationship between each index and clinical curative effect, the correlation between Fe no level and inflammation and pulmonary function index were analyzed. Results 路the relationship between Fe no level and inflammation and pulmonary function index was compared with the normal control group. The levels of Eosn and Fe no in peripheral blood of COPD group were significantly higher than those in COPD group before treatment. The level of FEV1 / FEV1 / pred in PEF / FEV1 / FEV1 / pred was significantly lower than that in control group (P 0.05), and all indexes were significantly improved after treatment (P 0.05). The correlation analysis showed that the level of Fe no was positively correlated with the level of Eostion N in peripheral blood before treatment, and negatively correlated with the level of FEV1 / FEV1 / pred, and the level of Fe no was negatively correlated with the level of EosN in peripheral blood after treatment. There was no significant correlation between PEFV and FEV1 / FEV1 / pred. Conclusion the level of FeNO was significantly higher in patients with stable COPD. It is a sensitive index of airway inflammation. Combined with pulmonary function index, it will be helpful to evaluate the curative effect of ICS and guide the treatment.
【作者单位】：上海交通大学附属第一人民医院宝山分院呼吸内科;
【分类号】：R563.9

【相似文献】