Zietkowski Z, Kucharewicz I, Bodzenta-Lukaszyk A
Department of Allergology and Internal Diseases, Medical University of Bialystok, Sklodowska Street 24A, 15-276 Bialystok, Poland.
Respir Med. 2005 Jul;99(7):816-24. doi: 10.1016/j.rmed.2004.12.008.
The aim of the study was to evaluate the exhaled nitric oxide (F(ENO)) in clinically stable chronic obstructive pulmonary disease (COPD), its relationship to the severity of the disease, pulmonary function, smoking status, reversibility of airflow limitation, and ICS therapy. The study was conducted in 47 patients with COPD and 40 healthy controls. Flow/volume spirometry and F(ENO) measurement were performed before and after 2 months of ICS therapy. F(ENO) were significantly elevated in current smokers and ex-smoking COPD patients. In both groups of COPD patients inhaled corticosteroids (ICS) therapy caused a significant decrease in F(ENO) without significant changes in FEV1. A positive correlation between initial F(ENO) and postbronchodilator FEV1 (% predicted) was observed in the group of ex-smoking COPD patients, but not in the currently smoking COPD group. In both groups of COPD patients, the initial level of F(ENO) correlated with the reversibility of airway obstruction, the increase in postbronchodilator FEV1 and the decrease in F(ENO) following ICS treatment. F(ENO) increases in patients with stable COPD. ICS therapy decreased elevated F(ENO) levels in these patients without statistically significant changes in lung function. The selection of COPD patients with increased F(ENO) level and partial reversibility of airway obstruction should be helpful in terms of proposed ICS treatment.
本研究的目的是评估临床稳定期慢性阻塞性肺疾病（COPD）患者的呼出一氧化氮（F(ENO)），及其与疾病严重程度、肺功能、吸烟状况、气流受限可逆性和吸入糖皮质激素（ICS）治疗的关系。该研究纳入了47例COPD患者和40名健康对照者。在ICS治疗2个月前后进行流量/容积肺量计检查和F(ENO)测量。当前吸烟者和已戒烟的COPD患者的F(ENO)显著升高。在两组COPD患者中，吸入糖皮质激素（ICS）治疗均导致F(ENO)显著降低，而第一秒用力呼气容积（FEV1）无显著变化。在已戒烟的COPD患者组中，观察到初始F(ENO)与支气管扩张剂后FEV1（预测值%）之间呈正相关，但在当前吸烟的COPD组中未观察到。在两组COPD患者中，初始F(ENO)水平与气道阻塞的可逆性、支气管扩张剂后FEV1的增加以及ICS治疗后F(ENO)的降低相关。稳定期COPD患者的F(ENO)升高。ICS治疗降低了这些患者升高的F(ENO)水平，而肺功能无统计学显著变化。选择F(ENO)水平升高且气道阻塞部分可逆的COPD患者，对于拟行的ICS治疗可能会有帮助。
