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目的探讨呼出气一氧化氮(Fe NO)及脉冲振荡肺功能(IOS)与哮喘患者小气道功能的关系。方法选取2014年7月至2015年7月于山东大学齐鲁医院呼吸科门诊就诊的哮喘患者140例,其中小气道功能正常组69例,小气道功能异常组71例,分别测定Fe NO值、外周血嗜酸性粒细胞(EOS)及总免疫球蛋白E(Ig E)、肺功能及IOS。结果小气道功能异常组Fe NO、Ig E、阻抗面积(AX)、共振频率(Fres)及EOS水平明显高于小气道功能正常组,差异有统计学意义(P均<0.01);小气道功能异常组Fe NO、AX、Fres及EOS水平与最大呼气中期流量占百分比预计值(FEF25%-75%pred)呈负相关(r=-0.856,P<0.001;r=-0.851,P<0.001;r=-0.398,P=0.001;r=-0.288,P=0.014);标准回归系数绝对值的比较:Fe NO>AX>Fres>EOS;不同指标诊断哮喘小气道功能异常的预测价值:Fe NO联合AX及Fres>Fe NO>AX>Fres>EOS。结论 Fe NO水平和IOS指标是诊断哮喘小气道功能异常的敏感特异性指标;二者联合能更好地评估哮喘患者的小气道功能。
Objective To investigate the relationship between respiratory function of nitric oxide (NO) and impulsive pulmonary function (IOS) and airway function in asthmatic patients. Methods From July 2014 to July 2015, 140 patients with asthma were enrolled in the Department of Respiratory Clinic of Qilu Hospital of Shandong University. Among them, 69 patients with normal function of small airway and 71 patients with abnormal function of small airway were detected for Fe NO, Blood eosinophils (EOS) and total immunoglobulin E (Ig E), lung function and IOS. Results FeNO, IgE, AX, Fres and EOS in small airway dysfunction group were significantly higher than those in small airway function normal group (all P <0.01). Small airway function The levels of Fe NO, AX, Fres and EOS in the abnormal group were negatively correlated with the predicted maximum expiratory flow (FEF25% -75% pred) (r = -0.856, P <0.001; r = -0.851, P <0.001 ; r = -0.398, P = 0.001; r = -0.288, P = 0.014); Comparison of absolute values of standard regression coefficients: Fe NO> AX> Fres> EOS; Predicted value of different indexes in diagnosing asthma small airway dysfunction: Fe NO in conjunction with AX and Fres> Fe NO> AX> Fres> EOS. Conclusion The level of Fe NO and the index of IOS are sensitive and specific indexes for diagnosis of small airway dysfunction in asthma. The combination of the two can better evaluate the airway function of asthma patients.