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目的:探索FENO在基层医院慢性咳嗽诊治中的应用价值。方法:收集2016年1月至2016年12月我院呼吸科门诊就诊的慢性咳嗽患者,在行胸部CT检查、肺通气功能、支气管舒张试验、鼻窦CT检查等辅助检查,仍不能明确诊断的患者,在经验性治疗前进行FENO、咳嗽症状积分测定,予经验性的应用布地奈德福莫特罗粉吸入剂治疗,4周后观察患者症状、FENO变化情况,分析数据相关性。结果:1.慢性咳嗽予经验性治疗,约72%患者症状有效缓解,咳嗽症状积分、FENO较前明显降低。咳嗽缓解组患者FENO值下降程度远大于未缓解组患者。2.缓解组患者治疗后其FENO下降比例与咳嗽症状积分下降比例呈显著相关性。结论:1.在基层医院对于慢性咳嗽患者诊断困难者,应用FENO检测指标,可为诊断和治疗提供方向。2.基层医院慢性咳嗽患者,予经验性吸入激素与β2受体激动剂的复合制剂治疗,治疗效果良好。FENO一定程度上可预测慢性咳嗽患者吸入激素与β2受体激动剂的复合制剂治疗后的治疗效果。3.FENO作为气道炎症的监测指标,具有无创、操作简便、安全、患者接受度高等优点。
Objective: To explore the value of FENO in diagnosis and treatment of chronic cough in primary hospitals. Methods: Patients with chronic cough from January 2016 to December 2016 in our department were enrolled in this study. Their CT findings, thoracic CT examination, pulmonary ventilation, bronchodilator test, and CT scan of the nasal cavity were still not confirmed , FENO and cough symptom scores were measured before empirical therapy. The empirical application of budesonide formoterol powder inhaler was used. After 4 weeks, the symptoms and the changes of FENO were observed and the data correlation was analyzed. Results: 1. Chronic cough to empirical treatment, about 72% of patients effectively relieve symptoms, cough symptom scores, FENO significantly lower than the previous. FENO values in patients with cough relief were significantly lower than those in non-remission patients. The proportion of decline in FENO after treatment in remission group was significantly correlated with the decline of cough symptom scores. Conclusion: 1. In the primary hospital for the diagnosis of chronic cough in patients with difficulty, the application of FENO detection indicators, can provide direction for the diagnosis and treatment. 2. The grass-roots hospital patients with chronic cough, to the empirical inhaled corticosteroid and β2 receptor agonist combination therapy, the treatment effect is good. FENO to some extent can predict the treatment of patients with chronic cough inhaled corticosteroid and β2 agonist compound after treatment. 3.FENO as a monitoring indicator of airway inflammation, with non-invasive, easy to operate, safe, patient acceptance advantages.