摘要
Abstract
Objective To evaluate the clinical efficacy of budesonide/formoterol administered alone or in combination with ketotifen in peripheral blood in patients with Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome (ACOS) with different fractional exhaled nitric oxide (FeNO) levels.Methods We enrolled 86 ACOS patients who were screened from among inpatients admitted to the Department of Respiratory Medicine, the 2nd Affiliated Hospital of Wenzhou Medical University, and the Department of Respiratory Medicine, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, from January 2015 to January 2017. All subjects were assigned to a high FeNO group (FeNO>50 ppb,n=41) or moderate FeNO group (25 ppb<FeNO≤50 ppb,n=45), according to their FeNO level. The high FeNO group was further divided randomly into subgroups A (n=20) and B (n=21), and the moderate FeNO group was divided randomly into subgroups C (n=23) and D (n=22). All patients were treated with inhaled budesonide/formoterol (160μg/4.5μg, single inhalation each time, twice daily), and patients in subgroups A and C were additionally given 1 mg ketotifen by oral administration twice daily. The forced expiratory volume in one second/forced vital capacity (FEV1/FVC), percent of predicted FEV1 (FEV1％), FeNO, serum total IgE level, peripheral percentages of eosinophils (EOS％) and neutuophils (NEU％), and percentage of basophilic granulocytes (BAS％) before and after treatment were measured 8 weeks after, treatment, and any treatment-related adverse reactions were recorded. Results FEV1/FVC and FEV1％ were significantly increased and FeNO and serum total IgE level were significantly decreased in all patients 8 weeks post-treatment compared with prior to treatment (allP<0.05). After treatment, FEV1/FVC and FEV1％in A subgroup were higher than those of B subgroup, FeNO and serum total IgE level in A subgroup were lower than those in B subgroup. FEV1/FVC and FEV1％ were significantly higher in subgroup A compared with subgroup C 8 weeks post-treatment (P<0.05), while peripheral blood EOS％ was significantly higher and NEU％ was significantly lower in subgroup A compared with subgroup C before treatment (P<0.05). Peripheral blood EOS％ was significantly lower in subgroup A than in subgroup B at 8 weeks post-treatment (P<0.05), and significantly lower in subgroup C than in subgroup D (P<0.05). Peripheral blood EOS％was significantly increased in all four groups at 8 weeks post-treatment compared with before treatment (P<0.05). There were no significant differences in the incidence of adverse reactions among subgroups A (20.0％), B (23.8％), C (26.1％), and D (22.7％) (P=0.973).Conclusion ACOS patients with high FeNO have a high peripheral blood EOS％, and those with moderate FeNO have a high NEU％. Combined treatment with ketotifen and budesonide/formoterol is effective for ACOS patients with high FeNO, and may improve lung functions, with high safety. The combination of ketotifen and budesonide/formoterol may also has comparable improvements in lung functions in ACOS patients with moderate FeNO compared with budesonide/formoterol alone.关键词
酮替芬/哮喘/肺疾病,慢性阻塞性/重叠综合征/呼出气一氧化氮Key words
Ketotifen/Asthma/Pulmonary disease/chronic obstructive/Overlap syndrome/Exhaled nitric oxide分类
医药卫生
