Preventing the occurrence of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is a major therapeutic goal. We hypothesise that persistently increased levels of exhaled nitric oxide (FeNO) during follow-up can identify a group of COPD patients at higher risk of AECOPD. To test this hypothesis, we measured FeNO levels (HypAir FeNO®, Medisoft; Sorinnes, Belgium) prospectively in 226 clinically stable COPD outpatients at recruitment and during follow-up (at 6 and 12 months). Patients were stratified according to the number of visits with FeNO ≥20 ppb. FeNO was <20 ppb in all three visits in 44.2% of patients, 29.6% in visit 1 and 26.1% in visit 2 or 3. These three groups suffered progressively higher AECOPD rates during follow-up (0.67, 0.91 and 1.42, respectively, p<0.001). After adjusting for potential confounding variables (log-rank test), the hazard ratio for AECOPD was higher in the latter group (1.579 (95% CI 1.049–2.378), p=0.029). Likewise, time to first moderate and severe AECOPD was shorter in these patients. Finally, there was no relationship between FeNO levels and circulating eosinophils. Persistent FeNO levels ≥20 ppb in clinically stable COPD outpatients are associated with a significantly higher risk of AECOPD. Persistently elevated FeNO levels in COPD are associated with a higher risk of exacerbation http://ow.ly/fdPy30hdBzo

中文翻译：

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呼出气一氧化氮分数持续升高与 COPD 急性加重风险增加有关

预防慢性阻塞性肺疾病（AECOPD）急性加重的发生是主要的治疗目标。我们假设在随访期间呼出的一氧化氮 (FeNO) 水平持续升高可以识别一组具有较高 AECOPD 风险的 COPD 患者。为了验证这一假设，我们在招募和随访期间（6 个月和 12 个月）前瞻性地测量了 226 名临床稳定的 COPD 门诊患者的 FeNO 水平（HypAir FeNO®，Medisoft；Sorinnes，比利时）。根据 FeNO ≥ 20 ppb 的就诊次数对患者进行分层。44.2% 的患者在所有 3 次就诊中的 FeNO 均 <20 ppb，在第 1 次就诊中为 29.6%，在第 2 次或第 3 次就诊中为 26.1%。这三组患者在随访期间的 AECOPD 发生率逐渐升高（分别为 0.67、0.91 和 1.42， p<0.001）。在调整潜在混杂变量（对数秩检验）后，后一组的 AECOPD 风险比更高（1.579（95% CI 1.049–2.378），p=0.029）。同样，这些患者首次出现中度和重度 AECOPD 的时间较短。最后，FeNO 水平与循环嗜酸性粒细胞之间没有关系。在临床稳定的 COPD 门诊患者中，持续性 FeNO 水平≥20 ppb 与 AECOPD 风险显着升高相关。COPD 中持续升高的 FeNO 水平与更高的恶化风险有关 http://ow.ly/fdPy30hdBzo 在临床稳定的 COPD 门诊患者中，持续性 FeNO 水平≥20 ppb 与 AECOPD 风险显着升高相关。COPD 中持续升高的 FeNO 水平与更高的恶化风险有关 http://ow.ly/fdPy30hdBzo 在临床稳定的 COPD 门诊患者中，持续性 FeNO 水平≥20 ppb 与 AECOPD 风险显着升高相关。COPD 中持续升高的 FeNO 水平与更高的恶化风险有关 http://ow.ly/fdPy30hdBzo