Obstructive Lung Diseases: COPD I |

Clinical Research of Exhaled Nitric Oxide Measurements in Patients With Chronic Obstructive Pulmonary Disease FREE TO VIEW

Huiyuan Zhu, PhD; Guojun Zhang, PhD; Jingshuo Wu; Zhong Zhang; Yahong Lan; Qian Yang; Xiaolin Li; Lina Zhou; Aixin Zhang; Peipei Wu
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The First Affiliated Hospital of Zhengzhou University, Department of Respiratory Medicine, The Second People’s Hospital of Zhengzhou, Zhengzhou, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A369. doi:10.1016/j.chest.2016.02.384
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: To investigate the clinical value and significance of fractional exhaled nitric oxide (FeNO) in patients with chronic obstructive pulmonary disease (COPD).

METHODS: A total of 67 outpatients, including 35 cases with acute exacerbation of COPD and 32 cases with acute exacerbation of bronchial asthma, were recruited from the Department of Respiratory Medicine, The Second People’s Hospital of Zhengzhou (Zhengzhou, Henan, China), from September 2013 to February 2015. COPD or asthma was separately diagnosed according to the Global Initiative for Chronic Obstructive Disease (GOLD) criteria or the Global Institute for Asthma guidelines. Current smokers or patients who regularly take oral corticosteroid for at least one month were excluded from the study for fear of influence. According to the current guidelines (American Thoracic Society/European Respiratory Society, ATS/ERS, 2005), FeNO levels were measured by using nitric oxide analyzer and serum C-reactive protein (CRP), peripheral blood eosinophil rate (EOS%), pulmonary functions were also detected at the same time for all patients. Data were analyzed by the statistical package of social science(SPSS) for Windows, version 19.0 (SPSS Inc. USA IBM).

RESULTS: We found lower FeNO levels and EOS% in COPD patients than in asthma patients (17.41±13.84ppb versus 57.58±46.61ppb and 1.23±1.73 versus 8.42±7.38; P<0.01, respectively). FeNO levels in COPD patients were within Chinese healthy adult normal range (mean:16ppb,95%CI:5∼30ppb, P>0.05). Serum CRP levels in COPD patients were higher than in asthma patients (9.94 (60.10) versus 2.49 (11.79), P<0.05). Pulmonary function parameters (including FEV1, FEV1% pred, FVC, FVC% pred, FEV1/FVC and FEF25%, FEF50%, FEF75%) in asthma patients were better than in COPD patients (P<0.05, respectively). There was no correlation between FeNO and lung functions parameters, EOS% in COPD patients (P>0.05, respectively). In asthma patients we also found no correlation between FeNO and lung functions parameters (P>0.05, respectively), however, there was positive correlation between FeNO and EOS% (r=0.626, P<0.01).

CONCLUSIONS: FeNO may not be applied to assist the diagnosis of COPD, However, in combination with EOS%, serum CRP and lung functions, it might be used to distinguish COPD from asthma during exacerbations.

CLINICAL IMPLICATIONS: FeNO presents different clinical significance between COPD and asthma during exacerbations. This may imply different pathological mechanisms between the two diseases.

DISCLOSURE: The following authors have nothing to disclose: Huiyuan Zhu, Guojun Zhang, Jingshuo Wu, Zhong Zhang, Yahong Lan, Qian Yang, Xiaolin Li, Lina Zhou, Aixin Zhang, Peipei Wu

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