| Background and purpose: With the process of industrialization in cities,worsening atmospheric pollution and changes in people's life style,the incidence of bronchial asthma is on a rising trend in the world.According to different country reports,the prevalence of asthma in the world is 1-18%.The prevalence of asthma in China is showing an upward trend year by year and has become one of the important chronic airway diseases that seriously endanger people's health.It affects not only the patient's quality of life,but also life-threatening in times of seriousness.Bronchial Asthma(asthma)is a chronic inflammatory disease of the airways that is involved in various cellular components including eosinophils,mast cells,T lymphocytes,airway epithelial cells,and cellular components.This chronic inflammation leads to increased airway hyperresponsiveness.The clinical manifestations are repeated episodes of wheezing,shortness of breath,chest tightness or cough and other symptoms.They often attack or aggravate at night and in the early morning.Most patients can relieve themselves or relieve after treatment.Airway hyperresponsiveness and chronic airway inflammation are two basic characteristics of asthma,and asthma is also the most common chronic airway inflammatory disease in all age groups.Therefore,how to correctly evaluate airway hyperresponsiveness and chronic airway inflammation is the key to diagnosing and managing asthma patients.The pathological basis of bronchial asthma is usually chronic airway inflammation,but recent studies have shown that asthma has at least four different inflammatory phenotypes: eosinophilic,neutrophilic,mixed,,Less cell type(paucigranulocytic).Different types of inflammation have different clinical features,of which the most common type of eosinophilia,and the type of hormone therapy is the most sensitive.Therefore,assessing the inflammatory phenotype in patients with asthma is of particular importance for the choice of treatment regimen.Exhaled air nitric oxide(Fe NO)as a new type of response to the detection of asthma airway inflammation,with safety,simplicity,non-invasive and other advantages.For the first time in 1993,it was found to be significantly elevated in patients with asthma,and research on the determination of Fe NO has been underway for the last 20 years.2011 American Thoracic Society published a "clinical application of exhaled nitric oxide guide" established Fe NO determination can be used for the diagnosis of asthma,prognosis assessment and follow-up and many other aspects.And recommended the normal range of exhaled nitric oxide,Fe NO levels are: low levels(<25 ppb for adults,<20 ppb for children),intermediate levels(25 to 50 ppb for adults and 20 to 35 ppb for children)and high levels Adults> 50 ppb,Children> 35 ppb).To investigate the relationship between Fe NO levels and peripheral blood eosinophils,leukocytes,total serum Ig E and lung function in asthmatic patients.Comprehensive analysis of asthma patients to assess the correlation between indicators of chronic airway inflammation in order to facilitate clinicians to quickly,easily and effectively diagnose chronic airway inflammation,timely diagnosis and treatment of disease.Research methods:A total of 101 subjects with bronchial asthma admitted to Shengjing Hospital Affiliated to China Medical University from January 2016 to January 2018 were enrolled in this study: group A(Fe NO> 34 cases of group B(Fe NO: 25-50 ppb)as low risk group and 34 cases of group C(Fe NO: <25 ppb)as control group.2.Basic data collection: collect the gender,age,smoking status of the subjects,count peripheral blood eosinophils,peripheral white blood cells,total serum Ig E concentration,lung function and exhaled nitric oxide levels.3.Statistical analysis: using SPSS 24.0 software for statistical analysis.The data of all the medical records were advanced and normal tested.The data satisfying the normal distribution were expressed as mean ± standard deviation(x ± SD)and the non-normal distribution was median(interquartile range),M(P25,P75).Comparison of the composition of the count data using Chi-square test.The ANOVA was used to compare the multi-group comparisons with the normal distribution,and the non-parametric Kruskal-Wallia H test was used to compare the non-normal distribution multi-group comparisons.The correlation between Fe NO levels and peripheral blood eosinophils,leukocytes,serum total Ig E and pulmonary function were analyzed by Spearman correlation analysis,P <0.05 was considered statistically significant.Results: 1.This study first compares the gender,age,smoking status and other basic information of the three sets of medical records,the results were not statistically different(P> 0.05),excluding the impact of non-research indicators.There was no significant difference in the peripheral blood leucocytes and lung functions between the three groups(A,B and C)(P> 0.05).The total Ig E concentration in serum of group A,B and C and the difference of eosinophil in peripheral blood were statistically significant(P <0.01)Blood eosinophils in high-risk group and control group(A group and C group),low-risk group and control group(B group and C group),high-risk group and low-risk group(A group and B group)The results were statistically significant.Serum total Ig E concentrations in high risk group and control group(A group and C group),low risk group and control group(B group and C group)were statistically significant,but in high risk group and low risk(A group and B group)No significant difference between the two groups.In the last line correlation analysis,there was a positive correlation between Fe NO level and peripheral blood eosinophils and total serum Ig E(0.511,0.646,P <0.001).Conclusion:1.Pulmonary function tests(bronchodilator test,bronchial provocation test)can be used to confirm the diagnosis,but it can not assess the nature of chronic airway inflammation in patients with asthma,for the diagnosis of asthma patients,should further improve the exhaled nitric oxide detection,serum Total Ig E and blood routine examination,rapid and effective assessment of airway inflammation and inflammation type.Bronchial asthma patients with Fe NO levels and peripheral blood eosinophils,serum total Ig E concentrations were positively correlated,three indicators were elevated,you can quickly,safely and quickly assess the airway chronic asthma inflammation.3.Eosinophilic asthma is particularly sensitive to glucocorticoids,Fe NO level as a biomarker of airway eosinophilic inflammatory response,can quickly and accurately evaluate the sensitivity of asthma patients to hormones,for clinical further treatment to provide Strong evidence. |
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