呼出的一氧化氮预测慢性阻塞性肺疾病急性加重时的糖皮质激素反应
Exhaled Nitric Oxide Predicts Glucocorticoid Response in Acute Exacerbations of Chronic Obstructive Pulmonary Disease.
摘要(中文译文)
本研究回顾性评估了呼出气一氧化氮在预测慢性阻塞性肺疾病急性加重期患者糖皮质激素反应中的临床价值。根据入院时呼出气一氧化氮（FeNO）水平≥25 ppb的临界值，将患者分为两组：高FeNO组（n=61）和低FeNO组（n=61）。所有患者均接受标准基础治疗，包括吸入性糖皮质激素（ICS）、短效β2受体激动剂（SABA）和短效抗胆碱能药物（SAMA）。治疗亚组额外接受全身糖皮质激素治疗。本研究的主要结局为第1秒用力呼气容积（FEV1% pred）和慢性阻塞性肺疾病评估测试（CAT）评分的改善情况。次要结局包括住院时间的变化和呼出气一氧化氮水平。基线呼出气一氧化氮（FeNO）水平与血嗜酸性粒细胞计数呈正相关。在高水平FeNO组中，与对照组相比，治疗组患者的肺功能显著改善，慢性阻塞性肺疾病评估测试（CAT）评分降低，呼出气一氧化氮水平更低。相反，在低水平FeNO组中，治疗亚组与对照亚组之间未观察到显著差异。这些发现表明，基线呼出气一氧化氮可识别嗜酸性气道炎症并预测对糖皮质激素治疗的反应性，支持在慢性阻塞性肺疾病急性加重期进行个体化糖皮质激素治疗选择。本回顾性研究显示，基线呼出气一氧化氮可识别慢性阻塞性肺疾病急性加重期的嗜酸性气道炎症并预测糖皮质激素反应，支持个体化治疗并缩短住院时间。
Abstract
This retrospective study evaluated the clinical value of fractional exhaled nitric oxide in predicting glucocorticoid response in patients with acute exacerbations of chronic obstructive pulmonary disease. Based on the critical value of fractional exhaled nitric oxide (FeNO) levels ≥25 ppb at admission, patients were categorized into two groups: the high FeNO group (n = 61) and the low FeNO group (n = 61). All patients received standard basic treatment, which included inhaled corticosteroids (ICS), short-acting β2 receptor agonists (SABA), and short-acting anticholinergic drugs (SAMA). The treatment subgroup was administered additional systemic glucocorticoid therapy. The primary outcomes of this study were improvements in forced expiratory volume in 1 s (FEV1% pred) and the COPD Assessment Test (CAT) score. Secondary outcomes included changes in the duration of hospital stay and levels of exhaled nitric oxide. Baseline exhaled nitric oxide (FeNO) levels were positively correlated with blood eosinophil counts. In the high-level FeNO group, patients in the treatment group showed significant improvements in lung function, a reduction in the COPD Assessment Test (CAT) score, and lower exhaled nitric oxide levels compared with the control group. Conversely, in the low-level FeNO group, no significant differences were observed between the treatment and control subgroups. These findings indicate that baseline fractional exhaled nitric oxide can identify eosinophilic airway inflammation and predict responsiveness to glucocorticoid therapy, supporting personalized glucocorticoid treatment selection in acute exacerbations of chronic obstructive pulmonary disease. This retrospective study shows that baseline fractional exhaled nitric oxide identifies eosinophilic airway inflammation and predicts glucocorticoid response in acute exacerbations of chronic obstructive pulmonary disease, supporting personalized treatment and reducing hospital stay.
如何引用
AMA
Jiao Chen, Juanjuan Li, Wenbing Wang, Fang Wang, Quanfu Yang. Exhaled Nitric Oxide Predicts Glucocorticoid Response in Acute Exacerbations of Chronic Obstructive Pulmonary Disease.. Journal of visualized experiments : JoVE. 2026; doi:10.3791/70947.
APA
Jiao Chen, Juanjuan Li, Wenbing Wang, Fang Wang, Quanfu Yang (2026). Exhaled Nitric Oxide Predicts Glucocorticoid Response in Acute Exacerbations of Chronic Obstructive Pulmonary Disease.. Journal of visualized experiments : JoVE. https://doi.org/10.3791/70947
GB/T 7714
Jiao Chen, Juanjuan Li, Wenbing Wang, Fang Wang, Quanfu Yang. Exhaled Nitric Oxide Predicts Glucocorticoid Response in Acute Exacerbations of Chronic Obstructive Pulmonary Disease.[J]. Journal of visualized experiments : JoVE, 2026 doi:10.3791/70947.
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