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目的评价呼出气一氧化氮(FeNO)测定在咳嗽变异性哮喘患者分层管理中的应用价值。方法根据治疗前的FeNO值将80例咳嗽变异性哮喘患者均分为两组:A组FeNO≥50ppb;B组FeNO<50ppb。均给予布地奈德福莫特罗粉吸入剂吸入治疗;A组又分为常规剂量(A1)组和高剂量(A2)组,B组分为常规剂量(B1)组和低剂量(B2)组,每组20例。比较治疗前后咳嗽症状评分和FeNO值变化。结果治疗第4、8和12周,A2组咳嗽症状评分改善较A1组更显著[(2.71±0.65)分vs.(3.31±0.77)分、(1.23±0.41)分vs.(3.21±0.87)分和(0.99±0.52)分vs.(2.89±0.69)分](P<0.05)。B1组和B2组治疗前后咳嗽症状评分无统计学差异(P>0.05)。治疗第8和12周,A2组FeNO值下降较A1组更显著[(30.33±5.78)ppb vs.(57.32±9.21)ppb和(18.45±6.23)ppb vs.(55.49±7.90)ppb](P<0.01)。B1组和B2组治疗前后FeNO值无统计学差异(P>0.05)。结论 FeNO测定在咳嗽变异性哮喘患者实施分层治疗管理中有重要价值,根据FeNO值选择不同优化给药方案患者可能获益更多。
Objective To evaluate the value of measuring exhaled nitric oxide (FeNO) in stratified management of patients with cough variant asthma. Methods Eighty patients with cough variant asthma were divided into two groups according to FeNO value before treatment: FeNO≥50ppb in group A and Fepp <50ppb in group B. (Group A1) and high dose (group A2). Group B was divided into two groups: conventional dose (B1) and low dose (B2) Group, 20 cases in each group. Cough symptom score and FeNO value before and after treatment were compared. Results At the 4th, 8th and 12th weeks of treatment, the improvement of cough symptom score in A2 group was more significant than that in A1 group (2.71 ± 0.65 vs 3.31 ± 0.77, 1.23 ± 0.41 vs 3.21 ± 0.87, Points and (0.99 ± 0.52) points vs. (2.89 ± 0.69) points respectively (P <0.05). There was no significant difference in cough symptom scores between B1 and B2 groups before and after treatment (P> 0.05). The decrease of FeNO in group A2 was more significant than that in group A1 [(30.33 ± 5.78) ppb vs. (57.32 ± 9.21) ppb and (18.45 ± 6.23) ppb vs. (55.49 ± 7.90) ppb] at weeks 8 and 12 <0.01). There was no significant difference in FeNO between B1 and B2 before and after treatment (P> 0.05). Conclusion The FeNO assay is of great value in the management of stratified treatment in patients with cough variant asthma. It may be more beneficial to choose different optimized dosage regimen according to the FeNO value.