title: Significance of fractional exhaled nitric oxide combined with serum procalcitonin and C-reactive protein in evaluation of elderly asthma.
abstract: Bronchial asthma is a common chronic airway inflammatory disease. Asthma is associated with high mortality, especially in the elderly patients. Repeated exacerbations cause disease progression. Therefore, identifying the onset of acute elderly asthma as soon as possible and giving the effective treatment is crucial to improve the prognosis. This study was to investigate the significance of fractional exhaled nitric oxide (FeNO) combined with serum procalcitonin (PCT) and C-reactive protein (CRP) in the evaluation of elderly asthma. A total of 120 elderly patients with an acute attack of asthma from July, 2010 to May, 2012 were studied. On presentation, FeNO, serum PCT and CRP concentrations were measured and sputum culture was also performed. The elderly patients were re-evaluated when they had returned to their stable clinical state. The elderly patients were classified into two groups: positive bacterial culture group (A) and negative bacterial culture group (B). The results showed that: (1) In patients with an acute exacerbation of asthma, 48 (40%) patients had positive sputum bacterial culture and 72 (60%) had negative sputum bacterial culture. (2) The levels of FeNO in patients with acute exacerbation of asthma were significantly higher than in those with no acute exacerbation state (63.8±24.6 vs. 19±6.5 ppb, P<0.05). There was no significant difference in FeNO between group A and group B (P>0.05). (3) The levels of PCT and CRP in group A patients with an acute exacerbation of asthma were significantly higher (P<0.05) than in group B (for PCT: 27.46±9.32 vs. 7.85±3.52 ng/mL; for CRP: 51.25±11.46 vs. 17.11±5.87 mg/L, respectively). When they had returned to stable clinical state, the levels of PCT and CRP in group A were decreased significantly (P<0.05), and those in group B had no significant change (P>0.05) when compared with the exacerbation group. There were no significant differences in the levels of PCT and CRP between the two groups in non-acute exacerbation state (P>0.05). These results suggest that the increase in FeNO indicates the acute exacerbation of asthma, and the elevation of serum PCT and CRP levels may be associated with bacterial infection.
authors.affiliation: Department of Respiratory Medicine and Intensive Care Union, the People's Hospital of Henan Province, Zhengzhou, 450003, China.
authors.forename: Ji-Zhen
authors.initials: JZ
authors.lastname: Wu
authors.affiliation: Department of Respiratory Medicine and Intensive Care Union, the People's Hospital of Henan Province, Zhengzhou, 450003, China.
authors.forename: Li-Jun
authors.initials: LJ
authors.lastname: Ma
authors.affiliation: Department of Respiratory Medicine and Intensive Care Union, the People's Hospital of Henan Province, Zhengzhou, 450003, China. zhaolimin2002@126.com.
authors.forename: Li-Min
authors.initials: LM
authors.lastname: Zhao
authors.affiliation: Department of Respiratory Medicine and Intensive Care Union, the People's Hospital of Henan Province, Zhengzhou, 450003, China.
authors.forename: Xiao-Yu
authors.initials: XY
authors.lastname: Zhang
authors.affiliation: Department of Respiratory Medicine and Intensive Care Union, the People's Hospital of Henan Province, Zhengzhou, 450003, China.
authors.forename: Xian-Liang
authors.initials: XL
authors.lastname: Chen
authors.affiliation: Department of Respiratory Medicine and Intensive Care Union, the People's Hospital of Henan Province, Zhengzhou, 450003, China.
authors.forename: Hong-Yan
authors.initials: HY
authors.lastname: Kuang
mesh_terms: D000368:Aged; D001249:Asthma / Q000175:diagnosis* / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D001944:Breath Tests / Q000379:methods*; D002097:C-Reactive Protein / Q000378:metabolism*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D045853:Exhalation; D005260:Female; D006801:Humans; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism*; D011498:Protein Precursors / Q000097:blood*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D009569:Nitric Oxide; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide