Feng Jia Xi, Lin Yun, Lin Jian, He Su Su, Chen Mei Fang, Wu Xiao Mai, Xu You Zu
Department of Respiratory Medicine, Taizhou Hospital of Zhejiang Province, Linhai, China.
J Korean Med Sci. 2017 Mar;32(3):439-447. doi: 10.3346/jkms.2017.32.3.439.
This study explored the relationship between the fractional exhaled nitric oxide (FeNO) level and the efficacy of inhaled corticosteroid (ICS) in asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) patients with different disease severity. A total of 127 ACOS patients with ACOS (case group) and 131 healthy people (control group) were enrolled in this study. Based on the severity of COPD, the ACOS patients were divided into: mild ACOS; moderate ACOS; severe ACOS; and extremely severe ACOS groups. We compared FeNO levels, pulmonary function parameters including percentage of forced expiratory volume in 1 second (FEV1) to predicted value (FEV1%pred), ratio of FEV1 to forced vital capacity (FEV1/FVC), inspiratory capacity to total lung capacity (IC/TLC) and residual volume to total lung capacity (RV/TLC), arterial blood gas parameters, including PH, arterial partial pressure of oxygen (PaO₂) and arterial partial pressure of carbon dioxide (PaCO₂), total serum immunoglobulin E (IgE), induced sputum eosinophil (EOS), plasma surfactant protein A (SP-A), plasma soluble receptor for advanced glycation end products (sRAGE), sputum myeloperoxidase (MPO), sputum neutrophil gelatinase-associated lipocalin (NGAL) and Asthma Control Test (ACT) scores, and COPD Assessment Test (CAT) scores. Compared with pre-treatment parameters, the FeNO levels, RV/TLC, PaCO₂, total serum IgE, induced sputum EOS, plasma SP-A, sputum MPO, sputum NGAL, and CAT scores were significantly decreased after 6 months of ICS treatment, while FEV1%pred, FEV1/FVC, IC/TLC, PH, PaO2, plasma sRAGE, and ACT scores were significantly increased in ACOS patients with different disease severity after 6 months of ICS treatment. This finding suggests that the FeNO level may accurately predict the efficacy of ICS in the treatment of ACOS patients.
本研究探讨了不同疾病严重程度的哮喘-慢性阻塞性肺疾病（COPD）重叠综合征（ACOS）患者呼出气一氧化氮分数（FeNO）水平与吸入性糖皮质激素（ICS）疗效之间的关系。本研究共纳入127例ACOS患者（病例组）和131例健康人（对照组）。根据COPD的严重程度，将ACOS患者分为：轻度ACOS；中度ACOS；重度ACOS；极重度ACOS组。我们比较了FeNO水平、肺功能参数，包括第1秒用力呼气容积（FEV1）占预计值百分比（FEV1%pred）、FEV1与用力肺活量比值（FEV1/FVC）、吸气容量与肺总量比值（IC/TLC）以及残气量与肺总量比值（RV/TLC）、动脉血气参数，包括pH值、动脉血氧分压（PaO₂）和动脉血二氧化碳分压（PaCO₂）、血清总免疫球蛋白E（IgE）、诱导痰嗜酸性粒细胞（EOS）、血浆表面活性蛋白A（SP-A）、血浆晚期糖基化终产物可溶性受体（sRAGE）、痰髓过氧化物酶（MPO）、痰中性粒细胞明胶酶相关脂质运载蛋白（NGAL）以及哮喘控制测试（ACT）评分和COPD评估测试（CAT）评分。与治疗前参数相比，ICS治疗6个月后，不同疾病严重程度的ACOS患者的FeNO水平、RV/TLC、PaCO₂、血清总IgE、诱导痰EOS、血浆SP-A、痰MPO、痰NGAL和CAT评分均显著降低，而FEV1%pred、FEV1/FVC、IC/TLC、pH值、PaO₂、血浆sRAGE和ACT评分均显著升高。这一发现表明，FeNO水平可能准确预测ICS治疗ACOS患者的疗效。
