Value of fractional exhaled nitric oxide in diagnosing of eosinophils bronchial asthma and in appraising of therapeutic reaction of inhaled corticosteroids for eosinophils bronchial asthma / 新乡医学院学报

ABSTRACT

Objective To determine the diagnostic value of ractional exhaled nitric oxide (FeNO) in eosinophils (EOS) bronchial asthma and its significance in appraising of therapeutic reaction of inhaled corticosteroids (ICS) for EOS bronchial asthma.Methods A total of sixty-two patients with bronchial asthma in the First Mfiliated Hospital of Xinxiang Medical University from April 2015 to February 2016 were selected as asthma group;at the same time,sixty-two healthy people were recruited as control group.The patients in asthma group were divided into EOS asthma group(n =31) and non EOS asthma group (n =31) according to the induced sputum cell count;the patients in EOS asthma group were divided into mild (n =7),moderate (n =13) and sever asthma group (n =1 1) according to the severity of the disease.The patients in asthma group were given conventional therapy(doxofylline 0.2 g intravenous infusion,two times per day;oral cetirizine 10 mg,one time per night;oral montelukast 10 mg,one time per night;budesonide 2 mg and compound ipratropium bromide solution 2.5 mL by aerosol rebreathing method,two times per day) for seven days.The pulmonary function,asthma control test(ACT) score,FeNO level and the ratio of EOS of patients were detected before and after treatment;the FeNO levels of person in the control group were tested.The FeNO levels of subjects were compared in each group;the correlation between FeNO level and EOS ratio was analysed in asthmatic group;the controlling rates of patients in asthmatic group were compared.Results Before treatment,the FeNO level in control group and asthma group was (9.57 ± 6.61),(30.23 ± 8.9 1) ppb respectively;the FeNO level in control group was significantly lower than that in asthma group (t =7.414,P ＜ 0.05).Before treatment,the FeNO level of patients in EOS asthma group and non EOS asthma group was (59.62 ± 29.04),(18.20 ± 11.33) ppb respectively;the FeNO level in non EOS asthma group was lower than that in EOS asthma group (t =6.568,P ＜ 0.05).In asthma group,the level of FeNO was positively correlated with EOS ratio(r =0.823,P ＜ 0.05).There was no statistic difference in FeNO level of patients in non EOS asthma group before and after treatment(t =2.013,P ＞ 0.05).The FeNO levels of patients in EOS asthma group after treatment were significantly lower than those before treatment (t =7.740,P ＜ 0.05);the FeNO levels of patients in mild,moderate and sever asthma group after treatment were significantly lower than those before treatment(t =3.535,8.171,7.161;P ＜0.05).The control rate of patients in EOS asthma group(67.7％,21/31) was significantly higher than that in the non EOS asthma group(22.6％,7/31) (x2 =12.765,P ＜0.05).The control rate of patients in mild,moderate and sever asthma group was 28.6％ (2/7),76.9 ％ (10/13) and 81.8 ％ (9/11) respectively;the control rate of patients in mild asthma group was significantly lower than that in moderate and sever asthma group (x2 =6.418,7.103;P ＜ 0.05);there was no statistic difference in control rate of patients between moderate asthma group and sever asthma group(x2 =7.103,P ＞ 0.05).Conclusion FeNO level can reflect the degree of airway inflammation,and can be used for the diagnosis of EOS phenotype asthma,and also has certain clinical value in evaluating the therapeutic reaction of ICS for treatment of EOS asthma.