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目的评价吸入β2受体激动剂对自发的气流阻塞哮喘患者FENO的影响。方法入选南方医院支气管舒张实验阳性的20例初诊哮喘患者和13例COPD患者,比较吸入400μg的沙丁胺醇后FeNO及肺功能改变,评价肺功能与FeNO及痰炎症细胞关系。结果 COPD患者诱导痰以中性粒细胞为主,初治哮喘患者诱导痰以嗜酸粒细胞为主。舒张前后FeNO水平哮喘组均显著高COPD组(P<0.05)。哮喘组吸入舒张剂后FeNO明显增高(P<0.05),COPD组未见显著差异。然而,吸入沙丁胺醇后FEV1%、FEV1%的改善率及其增加的绝对值(mL)与舒张前、舒张后的FeNO值,以及FeNO前后的改变值均未发现有显著相关关系。结论β2受体激动剂可以增加存在气流阻塞初治哮喘患者FeNO水平,其意义需进一步探讨。
Objective To evaluate the effect of inhaled β2-agonist on FENO in patients with spontaneous airflow obstruction of asthma. Methods 20 newly diagnosed asthmatic patients and 13 COPD patients who were positive in bronchial dilatation test of Southern Hospital were enrolled. The changes of FeNO and lung function after salbutamol inhalation were compared, and the relationship between lung function and FeNO and sputum inflammatory cells was evaluated. Results The majority of patients with COPD induced sputum mainly neutrophil. Patients with newly diagnosed asthma induced sputum to mainly eosinophils. Before and after diastole FeNO level asthma group were significantly higher COPD group (P <0.05). FeNO significantly increased (P <0.05) in inhaled diastolic agents and no significant difference in COPD patients. However, there was no significant correlation between FEV1% FEV1% improvement and its absolute value (mL) before and after salbutamol inhalation, before and after diastole, and before and after FeNO. Conclusions β2 agonists can increase FeNO levels in patients with newly diagnosed asthma with airflow obstruction, and its significance needs to be further explored.