Meta Analysis Of The Relationship Between Exhaled Nitric Oxide (FeNO) And Asthma-chronic Obstructive Pulmonary Overlap Syndrome(ACOS)

Objective:To evaluate the clinical significance of exhaled nitric oxide(FeNO)in asthma-chronic obstructive pulmonary overlap syndrome(ACOS).Methods:The computer searched Pub Med,Embase,The Cochrane Library,Web of Science,CNKI,VIP Database,Wanfang Database,China Biomedical Literature Database(CBM)and other databases,and comprehensively collected the literature related to the detection of exhaled nitric oxide and ACOS.From the establishment of the database to December 2022,the quality of the literature was evaluated by using the NOS scale criteria for clinical studies that met the inclusion criteria.Revman5.4 software was used to analyze the progressive meta of FeNO between chronic obstructive pulmonary disease(COPD)and asthma-chronic obstructive pulmonary disease overlap syndrome(ACOS),asthma and asthma-chronic obstructive pulmonary disease overlap syndrome(ACOS),chronic obstructive pulmonary disease(COPD)and asthma.Results:After searching in the database,1285 articles were obtained,including 20 reviews,1 case report and 10 conference papers.Finally,10 articles met the inclusion criteria,with a total of 1354 patients,including 460 patients with COPD,461 patients with asthma and 433 patients with ACOS.The results of Meta analysis showed that 1.the level of FeNO in ACOS group was significantly higher than that in COPD group(MD=-16.68,95%CI=-22.46～-10.96,Z=5.71,P<0.05);2.The level of FeNO in the asthma group was significantly higher than that in the ACOS group(MD=7.99,95%CI=3.61～12.88,Z=3.57,P<0.05);3.The level of FeNO in asthma group was significantly higher than that in COPD group(MD=-24.5195%CI=-25.70～-23.32,Z=40.48,P<0.05),the difference was statistically significant.Conclusion:This study shows that the level of FeNO in patients with asthma is higher than that in patients with ACOS and COPD,and that in patients with ACOS is higher than that in patients with COPD,so exhaled nitric oxide has a certain clinical value in asthma-COPD overlap syndrome,which can be used as a biological index for clinical diagnosis of asthma-chronic obstructive pulmonary disease overlap syndrome and provide basis for early intervention and treatment of ACOS.