The Value Of FeNO In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective: To study the response to systemic glucocorticoid therapy in patients with acute exacerbation of chronic obstructive pulmonary disease with different FeNO levels,in order to provide clinical reference for the use of glucocorticoid in patients with acute exacerbation of chronic obstructive pulmonary disease.Method: A total of 105 patients with acute exacerbation of COPD who met the inclusion criteria were collected from our hospital.According to the baseline FeNO level measured at admission,the patients were divided into high-value FENO group(FeNO > 25ppb)and low-value FeNO group(FeNO≤25ppb).All patients received blood cell count,CRP,arterial blood gas analysis and other related clinical indicators and CAT scores on the first day of admission.All patients received intravenous glucocorticoid therapy for 5 days,and the rest of therapy were given appropriate treatment according to the recommendations of the guidelines and the actual conditions of the patients.On the sixth day of treatment,blood cell count,CRP,arterial blood gas analysis and other indicators of the two groups of patients were tested again and CAT scores were performed again.The changes of CAT score and various indexes in the two groups before and after treatment were analyzed.Results: There was no significant difference between the two groups in CRP and Pa CO2,CAT on d1 after admission(P > 0.05).There were no statistically significant differences between the two groups in CRP and Pa CO2 on admission to d6(P > 0.05).Intragroup comparison showed that CRP and Pa CO2 in d6 of patients with high FeNO value and low FeNO value decreased compared with D1 values of the two groups,and the difference was statistically significant(P < 0.05).However,Pa CO2 decreased more in patients with high FeNO value group than those with low Fen O value group,and the difference was statistically significant(P < 0.05).There was no statistically significant difference in CAT score of admission d6 between the two groups(P > 0.05).Intragroup comparison found that CAT score of d6 in FeNO high value group and FeNO low value group was decreased compared with d1,the difference was statistically significant(P <0.001),and the difference of CAT score decline between the two groups before and after treatment was compared.It was found that CAT score of d6 in patients with high FeNO value decreased more than d1,and the difference was statistically significant compared with patients with low FeNO value(P < 0.001).Conclusions: Systemic glucocorticoid therapy in patients with acute COPD exacerbation showed better response to overall treatment and greater improvement in clinical symptoms in patients with high FeNO level before treatment,indicating that FeNO may be an indicator to predict therapeutic responsiveness in patients with acute COPD exacerbation.