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呼出气一氧化氮测定对吸入糖皮质激素治疗慢性阻塞性肺疾病疗效的预测价值
引用本文:朱敏,唐学义,马希涛. 呼出气一氧化氮测定对吸入糖皮质激素治疗慢性阻塞性肺疾病疗效的预测价值[J]. 河南诊断与治疗杂志, 2012, 0(1): 46-48
作者姓名:朱敏  唐学义  马希涛
作者单位:河南省人民医院呼吸科,郑州市450003
摘    要:
目的探讨呼出气一氧化氮(fraction of exhaled nitric oxide,FENO)测定预测慢性阻塞性肺疾病(chronicobstructive pulmonary disease,COPD)患者吸入糖皮质激素(inhaled corticosteroid,ICS)治疗疗效的价值。方法 31例戒烟的重度COPD患者(第1s用力呼气容积(forced expiratory volume in one second,FEV1)占预计值百分比〈50%),试验前进行无ICS的洗脱期后,给予沙美特罗替卡松吸入剂500μg,2次/d,连用4周,测定试验前FENO和试验后肺功能变化。结果基线FENO与使用ICS后FEV1变化无相关性;对ICS有反应者(FEV1增加≥200mL)较对ICS无反应者FENO基线值明显增高(P=0.028),利用FENO诊断有反应者与无反应者的AUC为0.767。结论对已戒烟的重度COPD患者,FENO是一个较好的预测ICS治疗疗效的指标。

关 键 词:慢性阻塞性肺疾病  呼出气一氧化氮  吸入糖皮质激素

Detection of exhaled nitric oxide for predicting the effect of inhaled corticosteroid on chronic obstructive pulmonary disease
ZHU Min,TANG Xue-yi,MA Xi-tao. Detection of exhaled nitric oxide for predicting the effect of inhaled corticosteroid on chronic obstructive pulmonary disease[J]. Henan Journal of Diagnosis and Therapy, 2012, 0(1): 46-48
Authors:ZHU Min  TANG Xue-yi  MA Xi-tao
Affiliation:(Department of Pulmonary Medicine,Henan Provincial People's Hospital,Zhengzhou 450003,China)
Abstract:
Objective To explore the value of exhaled nitric oxide detection to predicting the effect of inhaled corticosteroid on chronic obstructive pulmonary disease.Methods After eluting without inhaled corticosteroid before the test,31 ex-smokers with severe chronic obstructive pulmonary disease(mean FEV150% of predicted) were administrated fluticasone propionate 500 μg twice a day for 4 weeks,and were measured fraction of exhaled nitric oxide before the test,and pulmonary function before and after the test.Results The baseline fraction of exhaled nitric oxide was not correlated with FEV1 responses after inhaled corticosteroid.Inhaled corticosteroid responders(increased FEV1≥200 mL had significantly higher baseline fraction of exhaled nitric oxide levels compared with non-responders(P=0.028).The AUC for fraction of exhaled nitric oxide to discriminate responders from non-responders had an area under curve of 0.767.Conclusion In ex-smokers with severe chronic obstructive pulmonary disease,fraction of exhaled nitric oxide is a good indicator to predict the effect of inhaled corticosteroid.
Keywords:Chronic obstructive pulmonary disease  fraction of exhaled nitric oxide  inhaled corticosteroid
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