呼出气一氧化氮检测对支气管哮喘患者长期管理的意义

目的探讨通过定期检测呼出气一氧化氮浓度（FeNO）,FeNO对支气管哮喘进行长期管理的意义。方法选择2010年12月~2012年11月在江门市人民医院门诊治疗的支气管哮喘病例57例,随机分为观察组（31例）和对照组（26例）;观察组依据FeNO使用沙丁胺醇气雾剂加沙美特罗氟替卡松吸入剂,对照组按照《支气管哮喘防治指南》使用沙丁胺醇气雾剂加沙美特罗氟替卡松吸入剂。两组于用药开始前和用药后第1~12个月测定FeNO及进行哮喘控制测试（ACT）评分。结果对观察组和对照组进行ACT评分比较,均较治疗前改善,且这种改善持续存在,但观察组优于对照组,差异有统计学意义（P〈0.05）。观察组和对照组FeNO均较治疗前改善,且这种改善亦持续存在,但观察组优于对照组,治疗后除第1、8个月外,其他月份的差异有统计学意义（P〈0.05）。结论根据FeNO进行支气管哮喘长期管理,能预防支气管哮喘症状的出现,更好控制支气管哮喘的症状和气道炎症;减少吸入激素等抗炎药物的用量。

Value of the fraction of exhaled nitric oxide in long-term management of patients with bronchial asthma

Objective To investigate the fraction of exhaled nitric oxide（FeNO） in the long-term management of patients with bronchial asthma. Methods From December 2010 to November 2012, 57 outpatients with bronchial asthma in the People＇s Hospital of Jiangmen City were selected and randomly divided into the observation group（31 cases） and the control group（26 cases）. The observation group were managed inhalation with Salbutamol Sulphate Aerosol and Salmeterol Xinafoate Fluticasone Propionate Powder according to FeNO; the control group were managed inhalation with Salbutamol Sulphate Aerosol and Salmeterol Xinafoate Fluticasone Propionate Powder according to ＂Prevention and treatment of bronchial asthma guidelines＂ from Respiratory Medicine Branch of Chinese Medical Association in 2006.Both of two groups were given the FeNO testand the asthma control test（ACT） before taking medicine and at the end of1st-12 th month after taking medicine. Results The score of ACT increased all in two groups, these increases were keeping all the time, but the observation group had more significant increase compared with the control group, the differences were statistically significant（P 〈0.05）. The FeNO decreased all in two groups, these decreases were keeping all the time. but the observation group had more significant decrease compared with the control group in most months（except 1st, 8th mouty） after taking medicine, the difference was statistically significant（P〈0.05）. Conclusion The long-term management of patients（except 1st, 8 th month） with bronchial asthma based on FeNO can prevent the symptoms of patients with bronchial asthma, control the symptoms and the airway inflammation of patients with bronchial asthma more effectively, reduce the doses of anti-inflammatory drugs like inhaled corticosteroid in patients with bronchial asthma.