呼出气一氧化氮检测在亚急性咳嗽临床诊治中的意义

doi:10.3969/j.issn.1006-6233.2022.05.031

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摘要 目的:探讨呼出气一氧化氮(FeNO)检测在亚急性咳嗽临床诊治中的价值。方法:选择171例我院呼吸内科就诊的亚急性咳嗽患者进行呼出气一氧化氮检测,对结果进行分析。结果:171例患者平均FeNO值为36.89±12.35,其中47.95%的患者为正常,18.13%为中间水平,33.92%为高水平。171例患者中PIC患者62例,平均FeNO值为23.05±15.03,83.87%的患者为正常,14.52%为中间水平,1.61%为高水平;CVA患者58例,平均FeNO值为78.36±22.67,其中1.72%的患者为正常,8.62%为中间水平,89.66%为高水平;UACS患者36例,平均FeNO值为16.76±7.88,其中63.89%的患者为正常,33.33%为中间水平,2.78%为高水平;EB患者10例,平均FeNO值为42.75±13.72,其中10.00%的患者为正常,50.00%为中间水平,40.00%为高水平;其它患者5例,平均FeNO值为15.38±6.62,其中100.00%的患者为正常,0.00%为中间水平,0.00%为高水平。各组平均FeNO值比较,CVA组与PIC、UACS、EB及其它组相比P<0.05,有统计学意义。EB组与PIC、UACS及其它组比较,P<0.05,有统计学意义,PIC组与UACS及其它组比较,P>0.05,无统计学意义,UACS与其它组比较,P>0.05,无统计学意义。CVA及EB组患者经吸入激素布地奈德治疗后68例患者均有效,其中CVA患者25例(43.10%)好转,33例治愈(56.90%),有效率100%。EB组患者6例(43.10%)好转,4例(40.00%)治愈,有效率100%。两组总有效率100%。两组FeNO水平均明显下降,与治疗前FeNO值相比有明显统计学差异。结论:呼出气一氧化氮检测在亚急性咳嗽的临床诊治中具有重要价值。对咳嗽变异性哮喘、嗜酸粒细胞性支气管炎的诊断具有重要意义,对亚急性咳嗽的治疗具有指导意义。

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关键词 ：亚急性咳嗽, 呼出气一氧化氮, 咳嗽变异性哮喘, 嗜酸粒细胞性支气管炎, 上气道咳嗽综合征, 感染后咳嗽

Abstract：Objective: To investigate the clinical value of exhaled nitric oxide (FeNO) in the diagnosis and treatment of subacute cough. Methods: 171 patients with subacute cough in respiratory medicine department of our hospital were selected to detect exhaled nitric oxide, and the results were analyzed. Results: The mean FeNO value of 171 patients was 36.89 ± 12.35, of which 47.95% were normal, 18.13% were intermediate and 33.92% were high. Among the 171 patients, there were 62 patients with pic, with an average FeNO value of 23.05±15.03. 83.87% of the patients were normal, 14.52% were intermediate and 1.61% were high; There were 58 patients with CVA, the mean FeNO value was 78.36 ± 22.67, of which 1.72% were normal, 8.62% were intermediate, and 89.66% were high; There were 36 patients with UACS, with an average FeNO value of 16.76 ± 7.88, of which 63.89% were normal, 33.33% were intermediate and 2.78% were high; There were 10 patients with EB, with an average FeNO value of 42.75 ± 13.72, of which 10.00% were normal, 50.00% were intermediate and 40.00% were high; There were 5 other patients with an average FeNO value of 15.38 ± 6.62, of which 100.00% were normal, 0.00% were intermediate and 0.00% were high. Compared with PIC, UACS, EB and other groups, the average FeNO value of CVA group was P<0.05, which was statistically significant. Compared with PIC, UACS and other groups, EB group had statistical significance (P<0.05). Compared with UACS and other groups, PIC group had no statistical significance (P>0.05). Compared with UACS and other groups, UACS had no statistical significance (P>0.05). 68 patients in CVA and EB groups were effective after treatment with inhaled hormone budesonide. Among them, 25 patients with CVA (43.10%) improved, 33 patients were cured (56.90%), and the effective rate was 100%. In EB group, 6 cases (43.10%) were improved, 4 cases (40.00%) were cured, and the effective rate was 100%. The total effective rate of the two groups was 100%. The level of FeNO in the two groups decreased significantly, which was significantly different from that before treatment. Conclusion: The detection of exhaled nitric oxide is of great value in the clinical diagnosis and treatment of subacute cough. It is of great significance for the diagnosis of cough variant asthma and eosinophilic bronchitis, and for the treatment of subacute cough.

Key words： Subacute cough Fractional exhaled nitric oxide Cough variant asthma Eosinophilic bronchitis Upper airway cough syndrome Postinfection cough

基金资助:北京市临床重点专科项目经费资助,(编号:京卫医(2020)129号)

通讯作者: 张杰

引用本文:

楚辉, 张杰. 呼出气一氧化氮检测在亚急性咳嗽临床诊治中的意义[J]. 河北医学, 2022, 28(5): 847-852.
CHU Hui, ZHANG Jie. Significance of Exhaled Nitric Oxide in Clinical Diagnosis and Treatment of Subacute Cough. HeBei Med, 2022, 28(5): 847-852.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2022.05.031 或 http://www.hbyxzzs.cn/CN/Y2022/V28/I5/847

[1] 中华医学会,中华医学会杂志社,中华医学会全科医学分会,等.咳嗽基层诊疗指南(2018年)[J].中华全科医师杂志,2019,3(18):207~219.
[2] 丁金盾,邱章伟,徐晓婷,等.呼出气一氧化氮与小气道功能预测咳嗽变异性哮喘患者支气管高反应性[J].临床肺科杂志,2022,27(2):169~173.
[3] Song WJ,Kim HJ,Shim JS,et al.Diagnostic accuracy of fractional exhaled nitric oxide measurement in predicting cough-variant asthma and eosinophilic bronchitis in adults with chronic cough:a systematic review and meta-analysis[J].Allergy Clin Immunol,2017,140(3):701~709.
[4] 中国医药教育协会慢性气道疾病专业委员会,中国哮喘联盟.呼出气一氧化氮检测及其在气道疾病诊治中应用的中国专家共识.[J].中华医学杂志,2021,10(38):3092~3114.
[5] Karrasch S,Linde K,Rucker G,et al.Accuracy of FENO for diagnosing asthma:a systematic review[J].Thorax,2017,72(2):109~116.
[6] Price DB,Buhl R,Chan A,et al.Fractional exhaled nitric oxide as a predictor of response to inhaled corticosteroids in patients with non-specific respiratory symptoms and insignificant bronchodilator reversibility:a randomized controlled trial[J].Lancet Respir Med,2018,6(1):29~39.
[7] Jiang M,Liu M,Wang Y,et al.Association between fractional exhaled nitric oxide and clinical characteristics and outcomes in patients with subacute cough[J].Clin Respir,2018,12(3):1068~1075.
[8] Lamon T,Didier A,Brouquieres D,et al.Exhaled nitric oxide in chronic cough:a good tool in a multi-step approach[J].Respir Med Res,2019,11(76):4~9.
[9] Sadeghi MH,Wright CE,Hart S,et al.Phenotyping patients with chronic cough:Evaluating the ability to predict the response to anti-inflammatory therapy[J].Ann Allergy Asthma Immunol,2018,120(3):285~291.
[10] OhMJ,LeeJY,LeeBJ,et al.Exhaled nitric oxide measurement is useful for the exclusion of nonasthmatic eosinophilic bronchitis in patients with chronic cough[J].Chest,2018,134(5):990~995.
[11] Song WJ,Won HK,Moon SD,et al.Could fractional exhaled nitric oxide test be useful in predicting inhaled corticosteroid responsiveness in chronic cough A systematic review[J].Allergy Clin Immunol,2017,5(1):135~143.
[12] Chen LC,Zeng GS,Wu LL,et al.Diagnostic value of FeNO and MMEF for predicting cough variant asthma in chronic cough patients with or without allergic rhinitis[J].Asthma,2021,58(3):326~333.