Fractional Exhaled Nitric Oxide is Associated with the Severity of Stable COPD
Fractional Exhaled Nitric Oxide is Associated with the Severity of Stable COPD
复制标题
呼出一氧化氮分数与稳定型慢性阻塞性肺病的严重程度相关
DOI：
10.1080/15412555.2019.1704231
复制
发表时间：
2020-02-29
影响因子：
2.2
通讯作者：
Huang, Kewu
中科院分区：
文献类型：
--
作者：
Liu, Xiaoqian;Zhang, Hong;Huang, Kewu
摘要呼出气一氧化氮（FeNO）在慢性阻塞性肺疾病（COPD）患者中的价值尚不清楚。我们的目的是评估FeNO是否是一个比血嗜酸性粒细胞计数更有价值的生物标志物，用于识别COPD的临床特征。招募时纳入了稳定的COPD患者（n = 390），并根据FeNO和血液嗜酸性粒细胞计数进行分层。比较两组患者的人口学特征、肺功能、St乔治呼吸问卷（SGRQ）、血清吸入性变应原特异性IgE水平及前12个月内的急性发作情况。通过二元回归分析检查了前12个月中度或重度急性发作的风险因素。横断面研究结果显示，167例患者的FeNO水平较高（≥25 ppb），223例患者的FeNO水平较低（<25 ppb）; 138例患者的血嗜酸性粒细胞计数较高（≥200个/μL），252例患者的血嗜酸性粒细胞计数较低（<200个/μL）。与高FeNO组相比，低FeNO组GOLD III ~ IV级患者比例较高，SGRQ评分较高，前12个月内加重次数较多，sIgE阳性比例较低（均P < 0.05）。但上述现象与血嗜酸性粒细胞计数无关。最后，高FeNO水平与前12个月较低的中度或重度急性加重相关（RR：0.541 [95%CI 0.319-0.917]，p = 0.023）。在稳定期COPD患者中，FeNO而不是血嗜酸性粒细胞计数与COPD严重程度和过敏性气道炎症相关。然而，FeNO在指导COPD患者个性化治疗中的作用需要进一步研究。
Abstract The value of fractional exhaled nitric oxide (FeNO) in patients with chronic obstructive pulmonary disease (COPD) remains unclear. We aimed to assess whether FeNO is a more valuable biomarker than blood eosinophil count for identifying clinical characteristics of COPD. Stable COPD patients (n = 390) were included and stratified by FeNO and blood eosinophil counts at recruitment. The demographic characteristics, lung functions, St George Respiratory Questionnaire (SGRQ), serum inhaled allergen-specific IgE and the exacerbations in the preceding 12 months were compared. Risk factors for moderate or severe exacerbation in the preceding 12 months were examined by binary regression analysis. The cross-sectional study showed that 167 patients had high level of FeNO (≥25 ppb) and 223 in low level (<25 ppb), while 138 patients had high blood eosinophil count (≥200 cells/μL) and 252 had low (<200 cells/μL). Compared with the high FeNO group, there were higher proportion of patients with GOLD III–IV, higher SGRQ scores, more exacerbations in the preceding 12 months, and with lower positive proportion of sIgE in the low FeNO group (p < 0.05 for all). However, these phenomena above were not associated with blood eosinophil count. Finally, high FeNO level was associated with a lower moderate or severe exacerbation in preceding 12 months (RR: 0.541 [95%CI 0.319–0.917], p = 0.023). In stable COPD patients, FeNO, but not blood eosinophil count was associated with the COPD severity and allergic airway inflammation. However, the role of FeNO in guiding personalized treatment of COPD patients need to be further investigated.