Shi Fei, Qiu Chen, Yu Jie, Yang Ying, Li Binbin, Feng Mengjie, Zhang Ting, Liu Wenwen
Emergency Department, Jinan University, The Second Clinical College, Shenzhen, China.
Respiratory Department, Jinan University, The Second Clinical College, Shenzhen, China.
Iran J Allergy Asthma Immunol. 2018 Jun;17(3):232-239.
The exact role of fractional exhaled nitric oxide (FeNO) in older patients with chronic inflammatory diseases including asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) remains unclear. This study aimed to investigate the differences in FeNO levels of elderly patients with ACO, asthma, COPD, and chronic cough. We conducted a retrospective study analysing the data of stable outpatients from Pulmonary Department of the Second Clinical College, Jinan University. All participants (Age≥55 years) were divided into the ACO group (n=19), asthma group (n=16), COPD group (n=25), and chronic cough group (n=22). The clinical data such as peripheral eosinophil counts, serum high sensitivity C-reactive protein (hs-CRP), FeNO, and spirometry was collected, and the correlations between FeNO levels and systemic markers or spirometric indices were analyzed. Patients with ACO and asthma had significantly elevated FeNO levels (37.7±16.5, and 36.3±17.7 ppb) compared with COPD, and chronic cough patients (21.9±10.3, and 16.1±8.8 ppb). The FeNO levels were negatively associated with forced expiratory volume in 1 second (FEV1, p=0.003), FEV1% predicted (p=0.012), and FEV1/forced vital capacity (FVC, p=0.002) in all groups. However, there were no significant correlation between FeNO levels and FVC, peripheral eosinophil counts, or serum hs-CRP (p>0.05). Elderly patients with ACO have higher levels of FeNO, when compared with patients with COPD or chronic cough. These findings suggest that FeNO measurement may provide an important implication for the etiological diagnosis of ACO in the elderly patients.
呼出气一氧化氮分数（FeNO）在包括哮喘-慢性阻塞性肺疾病（COPD）重叠综合征（ACO）在内的老年慢性炎症性疾病中的确切作用仍不清楚。本研究旨在调查老年ACO患者、哮喘患者、COPD患者和慢性咳嗽患者的FeNO水平差异。我们进行了一项回顾性研究，分析了暨南大学第二临床学院肺科稳定门诊患者的数据。所有参与者（年龄≥55岁）分为ACO组（n = 19）、哮喘组（n = 16）、COPD组（n = 25）和慢性咳嗽组（n = 22）。收集外周嗜酸性粒细胞计数、血清高敏C反应蛋白（hs-CRP）、FeNO和肺功能检查等临床资料，并分析FeNO水平与全身标志物或肺功能指标之间的相关性。与COPD患者和慢性咳嗽患者（分别为21.9±10.3和16.1±8.8 ppb）相比，ACO患者和哮喘患者的FeNO水平显著升高（分别为37.7±16.5和36.3±17.7 ppb）。所有组中，FeNO水平与第1秒用力呼气容积（FEV1，p = 0.003）、预测FEV1%（p = 0.012）和FEV1/用力肺活量（FVC，p = 0.002）呈负相关。然而，FeNO水平与FVC、外周嗜酸性粒细胞计数或血清hs-CRP之间无显著相关性（p>0.05）。与COPD患者或慢性咳嗽患者相比，老年ACO患者的FeNO水平更高。这些发现表明，FeNO检测可能为老年患者ACO的病因诊断提供重要线索。
