Abstract
Objective To explore the value of fractional exhaled nitric oxide (FeNO) in diagnosis and treatment of asthma -COPD overlap syndrome (ACOS). Methods A total of 195 patients categorized into elderly ACOS, asthma, COPD and chronic cough groups were consecutively admitted from September 2013 to June 2014 in our hospital. All patients were examined with chest imaging, fractional exhaled nitric oxide (FeNO) test, and pulmonary function tests to analyze the differences in FeNO, FEV1/pred% and FEV1/FVC among four groups, and to detect the relevance of FeNO to FEV1/pred% and FEV1/FVC within each group. Results Both of the ACOS and asthma groups had higher FeNO values than the COPD and control groups [(30.9 ±27.8 , 34.5 ±29.4) vs. (17.3 ±9.9 , 16.1 ±8.6) , P <0.05 ] ,while the values of FEV1/pred% and FEV1/FVC in the ACOS and COPD groups were significantly lower than those in the other two groups [FEV1 /pred% , (52.9 ±8.4 , 53.5 ±9.6) vs. (81.1 ±5.9 , 85.7 ±7.1) , allP <0.05 ; FEV1 /FVC , (51.9 ±7.2 , 50.7 ± 7.1) vs. (79.2 ± 4.8 , 81.0 ± 5.9) , allP <0.05 ]. Although FeNOwas directly related to FEV1/pred% in the control group, there were no significant correlation between FeNO and FEV1/pred% (or FEV1/FVC) in the other three groups [ACOS group, r =0.115 , -0.007 (P =0.464 , 0.963) ; asthma group, r =0.038 , 0.045 (P =0.772 , 0.733) ; COPD group, r =0.097 , 0.010 (P =0.498 , 0.944) ; control group , r =0.315 , 0.091 (P =0.045 , 0.571) ]. Conclusions The combination of FeNO and pulmonary function tests can facilitate the differential diagnosis of ACOS and other chronic obstructive airways disorders. For the elderly COPD patients with higher FeNO values, it should be noted whether they were complicated by ACOS or not. Furthermore, the inhalation of corticosteroid can be used to reduce the airway inflammation in these patients. Key words: Fractional exhaled nitric oxide; Asthma-COPD overlap syndrome; Chronic obstructive pulmonary disease; Asthma; Elderly; Pulmonary function test; Diagnosis; Treatment
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