中南大学学报（医学版）
中南大學學報（醫學版）
중남대학학보（의학판）
JOURNAL OF CENTRAL SOUTH UNIVERSITY (MEDICAL SCIENCES)
2014年
4期
365-370
,共6页
夏清%潘频华%王展%陆蓉莉%胡成平
夏清%潘頻華%王展%陸蓉莉%鬍成平
하청%반빈화%왕전%륙용리%호성평
呼出气一氧化氮%支气管哮喘%慢性阻塞性肺疾病%肺功能
呼齣氣一氧化氮%支氣管哮喘%慢性阻塞性肺疾病%肺功能
호출기일양화담%지기관효천%만성조새성폐질병%폐공능
fraction of exhaled nitric oxide%asthma%chronic obstructive pulmonary disease%lung function
目的：探讨呼出气一氧化氮水平(fractional exhaled nitric oxide，FeNO)在支气管哮喘、慢性阻塞性疾病(chronic obstructive pulmonary diseases，COPD)中的变化情况及与肺功能中第1秒用力呼气量(forced expiratory volume in the ifrst second，FEV1)、第1秒用力呼气量占用力肺活量的百分比(forced expiratory volume in the ifrst second / forced vital capacity，FEV1/FVC)的相关性。方法：选取57例疑似支气管哮喘患者(21例为急性发作期、12例为非急性发作期、24例为非支气管哮喘)、38例COPD患者(25例为急性加重期、13例为稳定期)、26例正常对照者，分别测定FeNO， FEV1，FEV1/FVC，并进行统计学分析。结果：在FeNO诊断支气管哮喘中，若FeNO以20.15 PPb为切点，57例疑似支气管哮喘患者诊断为支气管哮喘的阳性预测值94.1%，阴性预测值95.7%，灵敏度97.0%，特异度91.7%；33例确诊为支气管哮喘患者的FeNO与26例正常对照者比较，差异有统计学意义(P<0.05)；支气管哮喘非急性发作期患者FeNO较急性期显著下降，差异有统计学意义(P<0.05)，FEV1和FEV1/FVC差异无统计学意义(P>0.05)；支气管哮喘患者FeNO水平与FEV1和FEV1/FVC无明显相关性(r=-0.186，-0.236，均P>0.05)；38例COPD患者的FeNO，FEV1，FEV1/FVC与26例正常对照者比较，差异有统计学意义(均P<0.05)；25例COPD急性加重期患者FeNO，FEV1，FEV1/FVC与13例COPD稳定期比较，差异有统计学意义(均P<0.05)；13例COPD稳定期患者FeNO与正常对照者比较，差异无统计学意义(P>0.05)；COPD患者FeNO水平与FEV1和FEV1/FVC无明显相关性(r=-0.167，-0.285，均P>0.05)。结论：支气管哮喘患者FeNO水平显著升高，在用FeNO诊断支气管哮喘中，若FeNO以20.15 PPb为切点，则FeNO诊断该疾病有较高的灵敏度和特异性；急性发作期FeNO较非急性发作期明显升高，可用于评估支气管哮喘的控制程度。COPD患者FeNO在急性加重期升高，稳定期无明显升高。
目的：探討呼齣氣一氧化氮水平(fractional exhaled nitric oxide，FeNO)在支氣管哮喘、慢性阻塞性疾病(chronic obstructive pulmonary diseases，COPD)中的變化情況及與肺功能中第1秒用力呼氣量(forced expiratory volume in the ifrst second，FEV1)、第1秒用力呼氣量佔用力肺活量的百分比(forced expiratory volume in the ifrst second / forced vital capacity，FEV1/FVC)的相關性。方法：選取57例疑似支氣管哮喘患者(21例為急性髮作期、12例為非急性髮作期、24例為非支氣管哮喘)、38例COPD患者(25例為急性加重期、13例為穩定期)、26例正常對照者，分彆測定FeNO， FEV1，FEV1/FVC，併進行統計學分析。結果：在FeNO診斷支氣管哮喘中，若FeNO以20.15 PPb為切點，57例疑似支氣管哮喘患者診斷為支氣管哮喘的暘性預測值94.1%，陰性預測值95.7%，靈敏度97.0%，特異度91.7%；33例確診為支氣管哮喘患者的FeNO與26例正常對照者比較，差異有統計學意義(P<0.05)；支氣管哮喘非急性髮作期患者FeNO較急性期顯著下降，差異有統計學意義(P<0.05)，FEV1和FEV1/FVC差異無統計學意義(P>0.05)；支氣管哮喘患者FeNO水平與FEV1和FEV1/FVC無明顯相關性(r=-0.186，-0.236，均P>0.05)；38例COPD患者的FeNO，FEV1，FEV1/FVC與26例正常對照者比較，差異有統計學意義(均P<0.05)；25例COPD急性加重期患者FeNO，FEV1，FEV1/FVC與13例COPD穩定期比較，差異有統計學意義(均P<0.05)；13例COPD穩定期患者FeNO與正常對照者比較，差異無統計學意義(P>0.05)；COPD患者FeNO水平與FEV1和FEV1/FVC無明顯相關性(r=-0.167，-0.285，均P>0.05)。結論：支氣管哮喘患者FeNO水平顯著升高，在用FeNO診斷支氣管哮喘中，若FeNO以20.15 PPb為切點，則FeNO診斷該疾病有較高的靈敏度和特異性；急性髮作期FeNO較非急性髮作期明顯升高，可用于評估支氣管哮喘的控製程度。COPD患者FeNO在急性加重期升高，穩定期無明顯升高。
목적：탐토호출기일양화담수평(fractional exhaled nitric oxide，FeNO)재지기관효천、만성조새성질병(chronic obstructive pulmonary diseases，COPD)중적변화정황급여폐공능중제1초용력호기량(forced expiratory volume in the ifrst second，FEV1)、제1초용력호기량점용력폐활량적백분비(forced expiratory volume in the ifrst second / forced vital capacity，FEV1/FVC)적상관성。방법：선취57례의사지기관효천환자(21례위급성발작기、12례위비급성발작기、24례위비지기관효천)、38례COPD환자(25례위급성가중기、13례위은정기)、26례정상대조자，분별측정FeNO， FEV1，FEV1/FVC，병진행통계학분석。결과：재FeNO진단지기관효천중，약FeNO이20.15 PPb위절점，57례의사지기관효천환자진단위지기관효천적양성예측치94.1%，음성예측치95.7%，령민도97.0%，특이도91.7%；33례학진위지기관효천환자적FeNO여26례정상대조자비교，차이유통계학의의(P<0.05)；지기관효천비급성발작기환자FeNO교급성기현저하강，차이유통계학의의(P<0.05)，FEV1화FEV1/FVC차이무통계학의의(P>0.05)；지기관효천환자FeNO수평여FEV1화FEV1/FVC무명현상관성(r=-0.186，-0.236，균P>0.05)；38례COPD환자적FeNO，FEV1，FEV1/FVC여26례정상대조자비교，차이유통계학의의(균P<0.05)；25례COPD급성가중기환자FeNO，FEV1，FEV1/FVC여13례COPD은정기비교，차이유통계학의의(균P<0.05)；13례COPD은정기환자FeNO여정상대조자비교，차이무통계학의의(P>0.05)；COPD환자FeNO수평여FEV1화FEV1/FVC무명현상관성(r=-0.167，-0.285，균P>0.05)。결론：지기관효천환자FeNO수평현저승고，재용FeNO진단지기관효천중，약FeNO이20.15 PPb위절점，칙FeNO진단해질병유교고적령민도화특이성；급성발작기FeNO교비급성발작기명현승고，가용우평고지기관효천적공제정도。COPD환자FeNO재급성가중기승고，은정기무명현승고。
Objective: To explore the change of fractional exhaled nitric oxide (FeNO) and its correlation with forced expiratory volume in the ifrst second (FEV1), the ifrst second forced expiratory volume percentage of forced vital capacity (FEV1/FVC) in bronchial asthma and chronic obstructive pulmonary disease (COPD). Methods: FeNO, FEV1 and FEV1/FVC were measured in 57 suspected asthmatics (21 acute onsets, 12 non-acute and 24 non-asthma), 38 COPD patients (25 acute exacerbations and 13 stable stages) and 26 healthy subjects. Results: In the 57 suspected asthmatic patients, when the optimal cut off value of FeNO was 20.15 PPb, which was used to diagnose asthma and differentiate asthma and non-asthma, the positive predictive value, the negative predictive value, the sensitivity and the speciifcity was 94.1%, 95.7%, 97.0%, and 91.7% respectively. hTere was signiifcant difference in the FeNO level between the 33 asthmatics and 26 healthy subjects (P<0.05). There was also significant difference in the FeNO level between the acute onset and the non-acute (P<0.05), but not in the FEV1 and FEV1/FVC level (bothP>0.05). hTere was no signiifcant correlation between FeNO and FEV1, FEV1/FVC in patients with asthma (r=-0.186,-0.236, bothP>0.05). hTere was signiifcant difference in the levels of FeNO, FEV1 and FEV1/FVC between the 38 COPD patients and the 26 healthy subjects (all P<0.05), and also between the 25 acute exacerbations and 13 stable COPDs (allP<0.05), but not between the 13 stable COPDs and 26 healthy subjects (allP>0.05). FeNO was not correlated with FEV1 and FEV1/FVC level in COPD patients (r=-0.167,-0.285, bothP>0.05). Conclusion: FeNO level is increased obviously in patients with asthma. hTe optimal cut off value of FeNO at 20.15 PPb can differentiate asthma and non-asthma with high sensitivity and speciifcity. FeNO is higher for the acute onset than non-acute, which may be useful to evaluate the control degree. FeNO level is increased in COPD patients in the acute exacerbations, but there is no change in stable COPD patients compared with the healthy subjects.
