呼出气一氧化氮指导支气管哮喘患者使用吸入性糖皮质激素治疗效果的研究

目的：对呼出气一氧化氮（fractional exhaled nitric oxide，FeNO）指导支气管哮喘患者使用吸入性糖皮质激素（inhaled corticosteroids，ICS）治疗效果的分析。方法：选取2019年1—12月在南京鼓楼医院呼吸与危重症医学科收治的支气管哮喘患者，共38例，根据初始FeNO值分为观察组（FeNO>30 ppb）与对照组（FeNO≤30 ppb），2组患者均给予布地奈德福莫特罗或沙美特罗替卡松粉雾剂，对比2组患者用药后的支气管哮喘症状控制情况、炎症改善情况、症状缓解和消失时间、支气管哮喘症状控制水平和用药依从性。结果：观察组支气管哮喘症状总控制率（100%）明显大于对照组（73.68%）（P<0.05）；使用药物治疗后，观察组的FeNO值出现显著降低（P<0.01），与对照组相比ACT评分显著提高（P<0.01），症状缓解时间与症状消失时间明显减少（P<0.05）。2组患者治疗后的用药依从性良好，无明显差异（P>0.05）。结论：FeNO指导支气管哮喘患者使用ICS具有其独特的优势，是个性化评估和管理炎症性气道疾病的有利工具。

Fractional exhaled nitric oxide as a predictor of response to inhaled corticosteroids inasthmatics

OBJECTIVE Analysis of the fractional exhaled nitric oxide (FeNO) as a predictor of response to inhaled corticosteroids (ICS) in asthmatics.METHODS From January 2019 to December 2019, 23 asthmatics at Department of Respiratory Medicine of Nanjing Drum Tower Hospital were examined by FeNOanalyzer. According to the initial FeNO level, they were divided into observation group (FeNO>30 PPB) and control group (FeNO ≤ 30 PPB). All of them received budesonide/formoterol or salmeterol/fluticasone powder for inhalation. Treatment efficacies, inflammatory factors, duration of symptom remission and disappearance, asthma control test (ACT) score and medication compliance were compared between two groups.RESULTS After treatment, the total control rate of asthma symptoms was significantly higher in observation group than that in control group (100% vs. 73.68%, P<0.05). The value of FeNO significantly declined in observation group (P<0.01). ACT score significantly improved compared with control group (P<0.01) and duration of symptom remission and disappearance decreased significantly (P<0.05). Medication compliance also significantly improved (P<0.05). However, there was no significant inter-group difference (P>0.05).CONCLUSION As a predictor of response to inhaled corticosteroids in asthmatics, FeNO offers its unique advantages. It is a useful tool for individualized assessment and management of airway inflammatory diseases.