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目的:观察慢性阻塞性肺疾病急性加重期(AECOPD)患者治疗前后呼出气一氧化氮(FeNO)浓度及外周血清总IgE水平的变化,探讨其临床意义及两者之间的相关性。方法:选择AECOPD患者、新诊断为支气管哮喘患者和健康者各20例,观察3组之间FeNO浓度及外周血清总IgE测定水平的差异。比较AECOPD组治疗前后FeNO浓度及外周血IgE水平的变化,并分析FeNO与外周血IgE之间相关性。结果:治疗前与健康组相比,AECOPD组FeNO浓度及血IgE水平显著增加,但低于支气管哮喘组,3组间差异有统计学意义(P<0.05)。AECOPD组治疗后与治疗前比较,FeNO浓度及血IgE水平明显降低,差异均有统计学意义(P<0.05)。AECOPD组治疗后FeNO浓度与血IgE水平与健康组比较,差异均有统计学意义(P<0.05)。AECOPD患者的FeNO浓度与血IgE水平之间无明显相关性。结论:AECOPD患者的FeNO和IgE产生增加,测定AECOPD患者FeNO可以评价气道炎症状态,指导治疗。测定FeNO对区分AECOPD与支气管哮喘有一定意义。
Objective: To observe the changes of exhaled nitric oxide (FeNO) and total serum IgE levels in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) before and after treatment, and to explore its clinical significance and the correlation between the two. Methods: AECOPD patients were selected and newly diagnosed as 20 cases of bronchial asthma and healthy persons respectively. The differences of FeNO concentration and total serum IgE levels between the three groups were observed. The changes of FeNO concentration and peripheral blood IgE before and after treatment in AECOPD group were compared, and the correlation between FeNO and peripheral blood IgE was analyzed. Results: Before treatment, FeNO concentration and serum IgE level in AECOPD group were significantly higher than those in healthy group, but were lower than those in bronchial asthma group. The difference was statistically significant (P <0.05). AECOPD group after treatment compared with before treatment, FeNO concentration and serum IgE levels were significantly lower, the difference was statistically significant (P <0.05). FeNO concentration and blood IgE levels in AECOPD group were significantly different from those in healthy group (P <0.05). There was no significant correlation between FeNO concentration and IgE level in AECOPD patients. CONCLUSIONS: FeNO and IgE production is increased in patients with AECOPD. The determination of FeNO in patients with AECOPD can evaluate the status of airway inflammation and guide the treatment. Determination of FeNO to distinguish between AECOPD and bronchial asthma have some significance.