呼出气一氧化氮、肺功能在慢性阻塞性肺疾

发布时间：2018-09-11 11:45

【摘要】：目的:本研究通过研究呼出气一氧化氮和肺功能在慢性阻塞性肺疾病与慢性阻塞性肺疾病合并支气管哮喘综合征(ACOS)之间的差异,初步探讨呼出气一氧化氮和肺功能在慢阻肺患者中筛选慢阻肺-哮喘重叠综合征的临床意义。方法:本研究采用病例-对照研究,收集2016年1月至2017年1月在新疆医科大学第五附属医院就诊的ACOS急性发作患者50例、慢阻肺急性发作患者50例。所有患者签署研究知情同意书。(1)临床资料收集:研究对象的年龄、性别、吸烟指数、血沉、血常规、血清总IgE、胸部X片。⑵研究内容:测定入选者肺功能指标,包括第一秒用力呼气容积(FEV1),用力肺活量(FVC)及两者的比值(FEV1/FVC),第一秒用力呼气容积占预计值百分比(FEV1%red)。(3)按美国胸科协会推荐的成人及儿童呼出气一氧化氮(FENO)水平测量技术的标准,我们采用Niox化学发光分析仪(Aerocrine,Solna,Sweden)检测FENO。重复测量3次,3次的测量结果要达到基本一致。结果:(1)ACOS组和慢阻肺组平均年龄分别为(72.2±11.8)岁和(71.2±10.8)岁,无显著差异(P0.05)。(2)ACOS组和慢阻肺组吸烟指数分别为(472±127)年支和(482±91)年支(P0.05)。(3)两组之间经卡方检验比较性别,P0.05,组间差异无统计学意义:(4)ACOS组FENO计数高于单纯COPD组(P0.05)。(5)ACOS组和慢阻肺组FENO分别为(55.2±27.3)ppb和(19.1±10.1)ppb(P0.05)。(6)以45ppb为切点,FENO的增高率,ACOS组(88.0%)显著高于慢阻肺组(10.0%)(P0.01)。(7)FVC、FEV1/FVC、FEV1%red在慢阻肺与ACOS之间无显著差异。结论:1.本研究FENO数值在ACOS组高于COPD组,当以45ppb为节点时ACOS组的增高率远远大于COPD组,提示了FENO在慢阻肺患者中初筛选哮喘-慢阻肺重叠综合征的具有一定应用价值。2.肺功能(FVC、FEV1/FVC、FEV1%red)在ACOS组与COPD组无明显差别,用于慢阻肺患者中初筛选哮喘-慢阻肺重叠综合征的价值不大。
[Abstract]:Objective: to study the difference of exhaled nitric oxide (no) and pulmonary function in (ACOS) between chronic obstructive pulmonary disease (COPD) and chronic obstructive pulmonary disease (COPD) with bronchial asthma syndrome. To explore the clinical significance of respiratory nitric oxide (no) and pulmonary function in screening COPD-asthma overlap syndrome. Methods: from January 2016 to January 2017, 50 patients with acute attack of ACOS and 50 patients with acute attack of chronic obstructive pulmonary disease (COPD) from January 2016 to January 2017 in the Fifth affiliated Hospital of Xinjiang Medical University were enrolled in this study. (1) Clinical data collection: age, sex, smoking index, erythrocyte sedimentation rate, blood routine examination, total serum IgE, chest X-ray. 2. It included forced expiratory volume (FEV1), forced vital capacity (FVC) and their ratio (FEV1/FVC), and forced expiratory volume in the first second (FEV1%red). (3) according to the standard of exhale nitric oxide (FENO) level in adults and children recommended by the American Thoracic Association. We use Niox chemiluminescence analyzer (Aerocrine,Solna,Sweden) to detect FENO.. The results of repeated measurements 3 times and 3 times should be basically consistent. Results: (1) the average age of ACOS group and COPD group were (72.2 卤11.8) years and (71.2 卤10.8) years, respectively. There was no significant difference (P0.05). (2) between the two groups (P0.05). (2). The smoking index of ACOS group and chronic obstructive lung group were (472 卤127) years and (482 卤91) year branches respectively (P0.05). (3). There was no significant difference between the two groups by chi-square test (P 0.05). (4) the FENO count of ACOS group was higher than that of COPD group (P0.05). (5) ACOS group and chronic obstructive lung group (P 0.05). The increase rate of FENO in 45ppb group (88.0%) was significantly higher than that in chronic obstructive lung group (10.0%) (P0.01). (7). There was no significant difference between 45ppb and ACOS. Conclusion 1. The FENO value of this study was higher in ACOS group than in COPD group, and the increase rate in ACOS group was much higher than that in COPD group when 45ppb was used as the node. It suggested that FENO was valuable in screening the asthmatic / chronic obstructive lung overlap syndrome in COPD patients. Pulmonary function (FVC,FEV1/FVC,FEV1%red) had no significant difference between ACOS group and COPD group.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.9;R562.25

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