Exhaled nitric oxide and hydrogen peroxide in patients with chronic obstructive pulmonary disease - Effects of inhaled beclomethasone
Exhaled nitric oxide and hydrogen peroxide in patients with chronic obstructive pulmonary disease - Effects of inhaled beclomethasone
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DOI：
10.1164/ajrccm.164.6.2012139
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发表时间：
2001-09-15
影响因子：
24.7
通讯作者：
Chapman, KR
中科院分区：
文献类型：
--
作者：
Ferreira, IM;Hazari, MS;Chapman, KR
关于吸入皮质类固醇在慢性阻塞性肺疾病（COPD）中的作用存在争议。虽然它们似乎对气道阻塞或其进展没有什么影响，但它们的使用可能会降低一部分患者发作的频率和/或严重程度。我们进行了以下研究，以确定吸入皮质类固醇对气道炎症的两种非侵入性标志物的影响。我们以随机、双盲交叉的方式将20名稳定的非吸烟慢性阻塞性肺病患者分配到两个2周的治疗期，每天两次吸入倍氯米松或匹配的安慰剂，然后是2周的洗脱期。我们每隔一周测量呼出一氧化氮（ENO）、呼出冷凝水H2O2和肺活量。中位基线ENO为26.2(19.3至54.8)ppb，在使用倍氯米松1周和2周后显著下降（分别为-10.6 ppb, p = 0.002和-6.3 ppb, p = 0.013），但吸入安慰剂没有变化。吸入倍氯米松或安慰剂后，呼吸冷凝水H2O2水平无显著变化。虽然BDP治疗后FEV1无显著变化，但ENO变化与FEV1变化呈中度负相关（r -0.50）。我们得出结论，吸入倍氯米松可降低稳定的非吸烟COPD患者的ENO水平，这一发现与抗炎作用机制相一致。
There is controversy about the role of inhaled corticosteroids in chronic obstructive pulmonary disease (COPD). Although they appear to have little impact on airways obstruction or its progression, their use may reduce the frequency and/or severity of exacerbations in a subset of patients. We undertook the following study to determine the impact of inhaled corticosteroid on two noninvasive markers of airways inflammation. We assigned 20 stable nonsmoking patients with COPD in random, double-blind crossover fashion to two 2-wk treatment periods with inhaled beclomethasone SOO mug twice daily or matching placebo, followed by a 2-wk washout period. We measured exhaled nitric oxide (ENO), breath condensate H2O2, and flow volume spirometry at weekly intervals. Median baseline ENO was 26.2 (19.3 to 54.8) ppb and fell significantly following 1 and 2 wk of beclomethasone (-10.6 ppb, p = 0.002, and -6.3 ppb, p = 0.013, respectively) but was unchanged by placebo inhalation. Breath condensate H2O2 levels did not change significantly with inhaled beclomethasone or placebo. Although there were no significant changes in FEV1 with BDP therapy, there was a moderate inverse correlation between changes in ENO and changes in FEV1 (r -0.50). We conclude that inhaled beclomethasone reduces ENO levels in stable nonsmoking patients with COPD, a finding compatible with an antiinflammatory mechanism of action.