作者：彭玉洁1 ，李传香2 ，方思2 ，汪晗希1 ，高杏林1 ，郭红荣2

单位：

1.430065湖北省武汉市，武汉科技大学医学部医学院　2.430074湖北省武汉市第三医院 武汉大学附属同仁 医院呼吸与危重症医学科

Units：

1.School of Medicine, Wuhan University of Science and Technology, Wuhan 430065, China 2.Department of Respiratory and Critical Care Medicine, Wuhan Third Hospital/Tongren Hospital, Wuhan University, Wuhan 430074, China

关键词：

肺疾病，慢性阻塞性；呼出气一氧化氮；肺泡一氧化氮；综述

Keywords：

Pulmonary disease, chronic obstructive; Fractional exhaled nitric oxide; Concentration of alveolar nitric oxide; Review

CLC：

R 563.9

DOI：

10.12114/j.issn.1008-5971.2023.00.327

Funds：

武汉市医学科研项目（WX20Q28）

摘要：

慢性阻塞性肺疾病（COPD）是以慢性呼吸系统症状、结构性肺异常以及持续气流受限为特征的临床 综合征。呼出气一氧化氮（FeNO）检查是近年来使用较多的一种无创性检查方法，其可通过评估支气管气道炎症病 变情况来判断气道功能。肺泡一氧化氮（CaNO）是外周/小气道炎症的标志物，越来越多的研究开始关注其在COPD患 者中的应用价值。本文首先分析了FeNO、CaNO与COPD发病机制、COPD患者急性加重风险的关系，然后探析了其在 鉴别COPD患者与哮喘合并COPD患者、监测吸入性糖皮质激素（ICS）治疗COPD效果中的应用价值，最后指出了其在 COPD患者中应用的局限性，这可为FeNO、CaNO在COPD患者中的应用及COPD患者早诊断、早治疗提供借鉴。

Abstract：

Chronic obstructive pulmonary disease (COPD) is a clinical syndrome characterized by chronic respiratory symptoms, structural lung abnormalities, and persistent airflow restriction. Fractional exhaled nitric oxide (FeNO) test is a non invasive examination method that has been widely used in recent years. It can assess airway function by assessing the bronchial airway inflammation. Concentration of alveolar nitric oxide (CaNO) is a marker of peripheral/small airway inflammation, and more and more studies have begun to focus on its application value in patients with COPD. This article first analyzes the relationship between FeNO, CaNO and the pathogenesis of COPD, as well as the risk of acute exacerbation in COPD patients. Then, it explores their application value in distinguishing COPD patients from asthma complicated with COPD patients, and monitoring the effectiveness of inhaled corticosteroids (ICS) in treating COPD, and finally points out the limitations of their application in COPD patients. This can provide reference for the application of FeNO and CaNO in COPD patients and early diagnosis and treatment of COPD patients.

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