The Study Of Changes In FeNO And Eosinophils Of Patients With Cough Variant Asthma During Follow-up

Purposes:Cough variant asthma(CVA)is a kind of asthma with cough as the main symptom.Because it lacks the typical symptoms of asthma,it is easy to lead to misdiagnosis,so that the patients suffer a long time of CVA and psychological pressure.At present,the airway inflammation and mental condition of patients with cough variant asthma have not been completely cleared.In this study,through up to six months of follow-up,observation and statistical analysis of the airway inflammation and mental status of patients with CVA.The result would provide a basis for in-depth understanding of the mechanism of CVA and provide a basis for developing the treatment strategies.Method:patients were inrolled at The First People’s Hospital of Yunnan Province from September 2018 to April 2020 who were diagnosed with CVA.The baseline data,lung function,fractional exhaled nitric oxide(Fe NO),induced sputum eosinophils(EOS)and peripheral blood EOS were collected and the Self-Rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)questionnaires were used as V0.Then all the patients received standardized treatment.Subsequently,the patients were followed up regularly,respectively in the second week(V1 phase),the first month(V2 phase),the second month(V3 phase),the third month(V4 phase),the fourth month(V5 phase),the fifth month(V6 phase)and the sixth month(V7 phase).The content of follow-up testing is the same as above.Subsequently,statistical analysis is performed on the collected data.Result:1.The Fe NO levels of 36 patients showed a significant decrease from 55.1±39.9ppb at the initial diagnosis to 31.4±23.7 ppb at V7 stage(p<0.01);2.Of the 29 patients who provided induced sputum analysis,14 had eosinophilic airway inflammation and 15 had non-eosinophilic airway inflammation.The sputum EOS of patients with eosinophilic airway inflammation decreased from23.1±21.6% at the V0 stage to 1.42±2.63% at the V7 stage,and there was a significant difference(p=0.0009);the sputum EOS of the patients with non-eosinophilic airway inflammation decreased from the VO stage0.72±0.52% decreased to 0.48±1.2%,no statistical difference.3.The peripheral blood EOS level of 36 patients decreased from 0.35±0.27×109/L at the initial diagnosis to 0.21±0.19×109/L of V7,with a significant difference(p=0.018);4.The results of the correlation analysis showed that the Fe NO level of patients at the initial diagnosis(V0 stage)was significantly positively correlated with FVC and FEV1 during the recovery phase(V7 stage),but was not significantly correlated with FEV1/FVC;the sputum EOS level at the initial diagnosis(V0stage)There is no significant relationship with FVC,FEV1 and FVC/FEV1 in the rehabilitation period(V7 stage);there is no significant relationship between the blood EOS level of patients at the initial diagnosis(V0 stage)and FVC,FEV1 and FVC/FEV1 in the rehabilitation period;5.At the first visit,4 of the 36 patients had depression and 7 patients had anxiety symptoms;by stage V7,4 patients had depression and 5 patients had anxiety,and there was no significant improvement.Conclusion:1.Fe NO and peripheral blood EOS of all patients with cough variant asthma decreased significantly during the visit period,and the induced sputum EOS of patients with eosinophilic airway inflammation also decreased significantly during the visit period;patients with non-eosinophilic airway inflammation Sputum EOS has been maintained at a very low level,and there was no significant change during the visit period.2.The Fe NO value of the patients at the first diagnosis are positively correlated with the pulmonary function during the recovery period.3.The risk of anxiety and depression is higher in patients with cough variant asthma.