呼出气一氧化氮测定在支气管哮喘诊治中的意义.docVIP

呼出气一氧化氮测定在支气管哮喘诊治中的意义 张雅军 （河南大学淮河医院， 河南 开封 475000） 摘要：目的　评估呼出气一氧化氮（fractional exhaled nitric oxide,FeNO）在支气管哮喘诊治中的意义。方法 选取未规范使用控制药物的哮喘患者30例，给予为期4周的布地奈德福莫特罗（信必可都保 160/4.5μｇ，bid）吸入治疗，检测治疗前后的FeNO水平、肺功能、ACT评分。同期选取30例健康受试者，给予检测FeNO及肺功能水平。结果　哮喘组患者吸入信必可治疗后的FeNO水平（体积分数）较治疗前显著降低（35.23±15.61 vs．66.81±38.57，P＜0.05）。治疗前的FeNO水平明显高于健康对照组（66.81±38.57 vs．18.62±11.30，P＜0.05），治疗后的FeNO水平也明显高于健康对照组（35.23±15.61 vs．18.62±11.30，P＜0.05）。治疗后的FEV1/pred较治疗前显著改善（83.45±14.56 vs.71.19±16.52,P＜0.05）；治疗后的ACT评分显著高于治疗前(22.46±2.06 vs.15.26±4.35,P＜0.05）；治疗前的FEV1/pred水平与ACT评分呈直线正相关（r=0.492,P＜0.01），FeNO与FEV1/pred及ACT评分无直线相关关系。结论　FeNO水平是一种评估气道炎症程度的参考指标，与肺功能及患者临床症状结合可以从不同的层面结合更好地反应哮喘的疾病控制程度。 关键词:　呼出气一氧化氮（FeNO）；支气管哮喘；　 中图分类号： R562.2 文献标识码：A Significance of fractional exhaled nitric oxide(FeNO)in the diagnosis and treatment of bronchial asthma ZHANG Ya-jun　 （Huaihe Hospital of Henan University,Kaifeng,Henan 475000,P.R.China） Abstract: 【Objective】 To evaluate the significance of fractional exhaled nitric oxide(FeNO) in the diagnosis and treatment of bronchial asthma.【Methods】 Thirty asthmatic patients without standard medication treatment were recruited.Budesonide Fomoterol(160/4.5ug,bid)was used for four weeks to evaluate the changes of FeNO Level,pulmonary functions and ACT scores. At the same time,thirty healthy people were recruited as control group and their FeNO levels and pulmonary functions were tested. 【Results】 After treated with Budesonide Fomoterol,the FeNO levels(volume fraction) of asthmatic patient were significantly lower than those before treatment（35.23±15.61 vs．66.81±38.57，P＜0.05）.Meanwhile,the FeNO levels of asthmatic patients were markedly higher than those of controllers before treatment （66.81±38.57 vs．18.62±11.30，P＜0.05）,and after treated（35.23±15.61 vs．18.62±11.30，P＜0.05）.After treatment with Budesonide Fomoterol,the FEV1/pred levels（83.45±14.56 vs.71.19±16.52 P＜0.05）,the ACT scores(22.46±2.06 vs. 15.26±4.35 ,P＜0.05）of asthmatic patients were significantly hig