Kim Bo-Guen, Shin Sun Hye, Yoo Jung-Wan, Jo Yong Suk, Park Hye Yun
Division of Pulmonary and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Tuberc Respir Dis (Seoul). 2024 Jul;87(3):329-337. doi: 10.4046/trd.2023.0175. Epub 2024 Mar 5.
Fractional exhaled nitric oxide (FeNO) is known to useful biomarker for detecting eosinophilic airway inflammation. However, there is a lack of evidence regarding the role of FeNO in chronic obstructive pulmonary disease (COPD). We aimed to assess whether elevated FeNO and its impact on treatment change into an inhaled corticosteroid (ICS)-containing regimen and association with acute exacerbation (AE) in patients with COPD.
We retrospectively analyzed 107 COPD patients without a history of asthma from March 2016 to December 2019. The patients whose FeNO value was more than 50 parts per billion (ppb) were defined into the high FeNO group. Multivariable analysis with logistic regression was used to identify factors associated with AE in COPD.
The median FeNO value was 32 ppb (interquartile range, 19 to 45) and 34 (20.0%) patients were classified as high FeNO group (median 74 ppb). In the high FeNO group, changes in inhaler treatment into an ICS-containing regimen occurred in 23 of 34 patients after the measurement of FeNO. In multivariate analysis, high FeNO was not a contributing factor for AE, but only the high blood eosinophil count (≥300 cells/μL) was associated with AE (adjusted odds ratio, 2.63; 95% confidence interval, 1.01 to 6.91; p=0.049).
High FeNO value had a significant impact on the prescription of ICSs in COPD patients, but it did not show a significant association with AE either on its own or with changes in treatment.
呼出一氧化氮分数（FeNO）是检测嗜酸性气道炎症的有用生物标志物。然而，关于FeNO在慢性阻塞性肺疾病（COPD）中的作用缺乏证据。我们旨在评估COPD患者中FeNO升高及其对治疗改为含吸入性糖皮质激素（ICS）方案的影响以及与急性加重（AE）的关联。
我们回顾性分析了2016年3月至2019年12月期间107例无哮喘病史的COPD患者。FeNO值超过50十亿分之一（ppb）的患者被定义为高FeNO组。采用逻辑回归进行多变量分析以确定与COPD患者AE相关的因素。
FeNO的中位数为32 ppb（四分位间距，19至45），34例（20.0%）患者被分类为高FeNO组（中位数74 ppb）。在高FeNO组中，34例患者中有23例在测量FeNO后吸入器治疗改为含ICS方案。在多变量分析中，高FeNO不是AE的促成因素，但只有高血嗜酸性粒细胞计数（≥300个细胞/μL）与AE相关（调整后的优势比，2.63；95%置信区间，1.01至6.91；p = 0.049）。
高FeNO值对COPD患者ICS的处方有显著影响，但它本身或与治疗变化均未显示与AE有显著关联。
