呼出气一氧化氮检测对咳嗽变异性哮喘糖皮质激素减量治疗的价值

发布时间：2019-03-06 07:50

【摘要】：目的探讨呼出气一氧化氮(FeNO)检测在咳嗽变异性哮喘糖皮质激素控制治疗中的意义。方法选取首次确诊并以吸入型糖皮质激素(ICS)为初始治疗的咳嗽变异性哮喘(CVA)患者43例。随机分成两组,肺功能(CON)组(n=21)根据CON指标,FeNO组(n=22)根据FeNO检测值,评判ICS减量的时机。每3个月为一随访阶段,随访12个月。比较两组患者年龄、体质量指数(BMI)、肺功能、FeNO值等基本特征,以及各阶段ICS使用量、平均使用量和复发率。结果第6个月~第9个月CON组ICS使用量为(204.76±31.23)μg·d-1,FeNO组为(131.82±16.63)μg·d-1,差异有统计学意义(P0.05);其余各阶段ICS使用量差异无统计学意义。整个随访过程中,平均ICS使用量,FeNO组[(249.55±15.58)μg·d-1]明显低于CON组[(310.00±22.60)μg·d-1],差异有统计学意义(P0.05)。与CON组比较,FeNO组复发率轻度增高,但差异无统计学意义。结论 FeNO可作为咳嗽变异性哮喘糖皮质激素治疗过程中的监测指标,对糖皮质激素的减量治疗具有指导作用。
[Abstract]:Objective to investigate the significance of exhaled nitric oxide (FeNO) in glucocorticoid-controlled treatment of cough variant asthma. Methods 43 (CVA) patients with cough variant asthma diagnosed for the first time and treated with inhaled glucocorticoid (ICS) were selected. Two groups were randomly divided into two groups: (CON) group (n = 21) and FeNO group (n = 22) according to CON index and FeNO group (n = 22), according to the value of FeNO, the timing of ICS reduction was evaluated. All patients were followed up every 3 months and followed up for 12 months. The age, body mass index (BMI), pulmonary function, Feno value, ICS usage, average usage and recurrence rate were compared between the two groups. Results the dosage of ICS was (204.76 卤31.23) 渭 g 路d ~ (- 1) in CON group and (131.82 卤16.63) 渭 g 路d ~ (- 1) in Feno group from 6th month to 9th month (P0.05). There was no significant difference in the use of ICS in other stages. During the whole follow-up, the average ICS usage in the FeNO group [(249.55 卤15.58) 渭 g 路d-1] was significantly lower than that in the CON group [(310.00 卤22.60) 渭 g 路d-1], the difference was statistically significant (P0.05). The recurrence rate of FeNO group was slightly higher than that of CON group, but there was no significant difference. Conclusion FeNO can be used as a monitoring index in the course of glucocorticoid therapy in cough variant asthma, and can be used as a guide for the treatment of glucocorticoid reduction in cough variant asthma.
【作者单位】：上海市长宁区中心医院呼吸科;
【分类号】：R562.25

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