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Objective: To study the response of patients of acute exacerbation of chronic obstructive pulmonary disease with different fractional exhaled nitric oxide (FENO) levels to glucocorticoid.
Methods: A total of 105 patients with acute exacerbation of COPD who met the inclusion and exclusion criteria were collected and divided into high FENO group (FENO >25 ppb) and low FENO group (FENO≤25 ppb) according to the FENO level at admission. Routine blood, CRP, blood gas analysis and other related indicators and CAT scores of patients were determined on the first day after admission. All patients were given systemic glucocorticoids for five days, and the rest of the treatment was correspondingly given in combination according to the guideline recommendations. After the treatment of 6 days, blood routine detection of two groups of patients, such as CRP, blood gas result and CAT scores, was recorded again. The changes of CAT score and various indexes before and after the treatment were statistically analyzed. The difference of CAT between the two groups was statistically significant (P<0.001).
Results: There was no significant difference in CAT scores between the two groups on the 6th day of treatment (P>0.05). The CAT scores of high FENO group and low FENO group after treatment were lower than those before treatment, with the difference statistically significant (P<0.001).
Conclusion: The patients with high FENO level before treatment have better response to the overall treatment and better clinical symptom improvement, which indicates that FENO may be a predictor of treatment response in patients with acute exacerbation of COPD.
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目的： 研究不同呼出气一氧化氮（FENO）水平的慢性阻塞性肺疾病（以下简称慢阻肺）急性加重患者对激素治疗的反应性。
方法： 收集满足入选标准和排除标准的慢阻肺急性加重期患者共105例，根据患者入院时FENO水平分为FENO高值组（FENO>25 ppb）和FENO低值组（FENO≤25 ppb），入院后d 1测定患者的血常规、C反应蛋白（CRP）、血气分析等相关指标以及慢阻肺患者自我评估测试（CAT）评分，所有患者均接受静脉激素治疗5 d，其余治疗根据指南推荐意见结合患者实际给予相应的治疗，在治疗d 6再次检测两组患者血常规、CRP、血气等指标以及CAT评分，统计并分析两组患者治疗前后CAT评分及各项指标的变化。
结果： 两组患者治疗d 6 CAT评分组间比较无统计学差异（P>0.05），组内比较FENO高值组与FENO低值组治疗后CAT评分均较治疗前下降，差异具有统计学意义（P<0.001），两组患者治疗前后CAT评分差值比较具有统计学意义（P<0.001）。
结论： 对慢阻肺急性加重期的患者给予激素治疗，治疗前FENO水平高的患者对总体治疗的反应性更好，临床症状改善更大，预示着FENO可能为慢阻肺急性加重期患者预测治疗反应性的一项指标。
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杨益成，男，硕士研究生，研究方向：慢性气道疾病。E-mail: yssskr@163.com。
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杨益成，男，硕士研究生，研究方向：慢性气道疾病。E-mail: yssskr@163.com。
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