慢性阻塞性肺疾病患者呼出气一氧化氮浓度变化及其临床意义

摘要

目的：观察慢性阻塞性肺疾病（ COPD）患者呼出气一氧化氮（ FENO）浓度变化，并探讨其临床意义。方法选取齐齐哈尔医学院第三附属医院呼吸科2013年3月—2014年3月收治的住院COPD患者120例，根据2009年慢性阻塞性肺疾病全球创议（ GOLD）分为GOLDⅠ级组、GOLDⅡ级组、GOLDⅢ级组、GOLDⅣ级组，每组30例；选取同期在齐齐哈尔医学院第三附属医院体检健康者100例作为对照组。检测各组受试者肺功能及FENO浓度，计算第一秒用力呼气容积（ FEV1）/用力肺活量（ FVC），FEV1占预计值百分比。结果 GOLDⅠ级组、GOLDⅡ级组、GOLDⅢ级组、GOLDⅣ级组患者FEV1/FVC、FEV1占预计值百分比低于对照组，FENO浓度高于对照组，GOLDⅡ级组、GOLDⅢ级组、GOLDⅣ级组患者FEV1/FVC、FEV1占预计值百分比低于GOLDⅠ级组，FENO浓度高于GOLDⅠ级组，GOLDⅢ级组、GOLDⅣ级组患者FEV1/FVC、FEV1占预计值百分比低于GOLDⅡ级组，FENO浓度高于GOLDⅡ级组，GOLDⅣ级组患者FEV1/FVC、FEV1占预计值百分比低于GOLDⅢ级组，FENO浓度高于GOLDⅢ级组（P﹤0.05）；Spearman等级相关分析结果显示，FENO浓度与GOLD分级呈正相关（r=0.776，P﹤0.01）。结论 COPD患者FENO浓度明显升高，且FENO浓度与COPD严重程度密切相关，检测FENO浓度对判断COPD患者病情严重程度及预后具有重要意义。%Objective To observe the changes of fraction of exhaled nitric oxide ( FENO ) in patients with chronic obstructive pulmonary disease( COPD),to explore its clinical significance. Methods From March 2013 to March 2014,a total of 120 inpatients with COPD were selected in the Department of Respiratory, the Third Affiliated Hospital of Qiqihaer Medical College,and they were divided into groups A( GOLD grade at Ⅰ),B( GOLD grade at Ⅱ),C( GOLD grade atⅢ),D(GOLD grade atⅣ)according to Chronic Obstructive Pulmonary Disease Global Initiatives(GOLD)in 2009,each of 30 cases;a total of 100 healthy cases were selected as control group. Lung function and FENO were detected,FEV1/FVC and FEV1 pre% were calculated. Results FEV1/FVC and FEV1 pre% of groups A, B, C, D were lower than those of control group,respectively,while FENO was higher than that of control group,respectively(P﹤0. 05);FEV1/FVC and FEV1pre%of groups B,C,D were lower than those of group A,respectively,while FENO was higher than that of group A,respectively (P﹤0. 05);FEV1/FVC and FEV1pre% of groups C,D were lower than those of group B,respectively,while FENO was higher than that of group B,respectively(P﹤0. 05);FEV1/FVC and FEV1pre% of group D were lower than those of group C, while FENO was higher than that of group C ( P ﹤0. 05 ). Spearman ranked correlation analysis showed that, FENO was positively correlated with GOLD grade(r =0. 776,P ﹤0. 01). Conclusion FENO is obviously elevated in patients with COPD,and it is positively correlated with the severity of COPD,the detection of FENO is with important clinical significance to judge the severity and prognosis of COPD.