糖皮质激素吸入对咳嗽变异性哮喘患者呼出气NO水平的影响

发布时间：2018-04-19 23:17

本文选题：糖皮质激素 + 咳嗽变异性哮喘　；参考：《重庆医学》2015年08期

【摘要】：目的观察咳嗽变异性哮喘(CVA)患者呼出气NO(FeNO)水平与气道炎症水平的关系,以及糖皮质激素对其的影响,并探讨其水平变化与气道炎症水平的关系。方法经支气管激发试验确诊的CVA患者14例,予以布地奈德/福莫特罗吸入剂吸入治疗,分别于治疗前及治疗6个月后测定其引起FEV1降低20%的乙酰甲胆碱浓度(PC20FEV1)、FeNO水平、诱导痰中嗜酸性粒细胞量及比例。结果 FeNO水平显著高于健康对照者,与PC20FEV1水平呈显著负相关,而与诱导痰嗜酸性粒细胞比例呈显著正相关。经布地奈德/福莫特罗吸入治疗6个月后气道反应性逐渐下降,其诱导痰中嗜酸性粒细胞比例亦显著下降。结论CVA患者FeNO水平显著升高,且此变化与患者气道炎症水平显著相关,而经吸入性糖皮质激素长效β2受体激动剂的联合制剂(ICS/LABA)治疗后,其水平显著下降,提示FeNO也许可以作为CVA患者气道炎症控制水平的标志。
[Abstract]:Objective to investigate the relationship between the level of exhalation and the level of airway inflammation and the effect of glucocorticoid on the level of airway inflammation in patients with cough variant asthma (CVA) and to explore the relationship between the changes of the level and the level of airway inflammation. Methods fourteen patients with CVA diagnosed by bronchial provocation test were treated with budesonide / formoterol inhaled. The levels of PC20FEV1 and FeNO were measured before and after 6 months of treatment. Amount and proportion of eosinophils in induced sputum. Results the level of FeNO was significantly higher than that of healthy controls, and negatively correlated with the level of PC20FEV1, but positively correlated with the percentage of eosinophils in induced sputum. After inhaled with budesonide / formoterol for 6 months, airway reactivity decreased gradually, and the percentage of eosinophils in sputum decreased significantly. Conclusion the level of FeNO in patients with CVA was significantly increased, and the change was significantly correlated with the level of airway inflammation. However, after treatment with inhaled glucocorticoid long-acting 尾 _ 2-receptor agonist, the level of FeNO was significantly decreased after treatment with ICS / L _ (BA), a combination of inhaled glucocorticoid and 尾 _ 2-receptor agonist. The results suggest that FeNO may be a marker of airway inflammation control level in CVA patients.
【作者单位】：成都军区总医院呼吸内科;第三军医大学新桥医院呼吸疾病研究所;
【基金】：国家自然科学基金资助项目(30900657) 成都军区总医院院管基金资助项目(424121B7)
【分类号】：R562.25

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