目的 探讨外周血嗜酸性粒细胞百分比(EOS％)与呼出气一氧化氮(FeNO)测定对慢性阻塞性肺疾病(COPD)稳定期患者吸入性糖皮质激素(ICS)疗效的预测价值.方法 收集2017年1月至2018年12月期间本院门诊就诊的COPD稳定期患者78例,进行无ICS治疗洗脱期后测定EOS％、FeNO、肺功能指标[用力肺活量(FVC)、第一秒用力呼气量(FEV1)、最大呼气流速(PEF)],采用慢性阻塞性肺病评估测试(CAT)问卷评估症状严重程度,给予ICS治疗4周复查上述指标,根据肺功能和CAT改善情况分为有效组和无效组,采用Pearson相关分析和ROC曲线分析EOS％和FeNO对ICS疗效的预测价值 ICS治疗后,EOS％和FeNO较前降低,FVC、FEV1、PEF较前升高,CAT评分较前下降,差异有统计学意义(P＜0.05);治疗前EOS％和FeNO水平与FEV1改善量呈正相关(r =0.412、0.397,P＜0.05),与FVC、PEF、CAT评分改善量无相关性(P＞0.05).有效组治疗前后FeNO水平分别高于同期无效组,差异有统计学意义(P＜0.05),治疗前、治疗后EOS％水平在两组间差异无统计学意义(P＞0.05).治疗前EOS％对ICS疗效预测的ROC曲线下面积为0.531(P＞0.05),临界值为3.13％,灵敏度和特异度分别为57.1％和52.4％;治疗前FeNO对ICS疗效预测的ROC曲线下面积为0.628(P＜0.05),临界值为30.00 ppd,灵敏度和特异度分别为64.6％和91.0％.结论对于COPD稳定期患者,EOS％和FeNO水平与ICS治疗后FEV1改善量呈正相关,二者可一定程度预测ICS疗效,且FeNO较EOS％有更高的预测价值,可推广应用于临床.“,”Objective To investigate the predictive value of peripheral blood eosinophil percentage (EOS％) and exhaled nitric oxide (FeNO) on the efficacy of inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD) at stable stage.Methods A total of 78 patients with stable COPD during the outpatient clinic from January 2017 to December 2018 were enrolled.EOS％,FeNO,and pulmonary function indicators [forced vital capacity (FVC),forced expiratory volume in 1 sec (FEV1),peak expiratory flow (PEF)] were measured after ICS-free elution.The questionnaire was used to assess the severity of the symptoms.The above indicators were reviewed after 4 weeks of ICS treatment.According to the improvement of pulmonary function and chronic obstructive pulmonary disease assessment (CAT) improvement,the patients were divided into effective and ineffective groups.Pearson correlation analysis and receiver operating characteristic (ROC) curve were used to analyze the predictive value of EOS％ and FeNO for ICS.Results After ICS treatment,EOS％ and FeNO were lower,FVC,FEV1,and PEF were higher than before,and CAT score was lower than before (P ＜ 0.05).There was a positive correlation between EOS％ and FeNO levels before treatment and the FEV1 improvement (r =0.412,0.397,P ＜ 0.05),and no correlation with the improvement of FVC,PEF and CAT scores (P ＞ 0.05).The FeNO level in the effective group was higher than that in the ineffective group before and after ICS treatment,with statistically significant difference (P ＜ 0.05).The pre-treatment EOS％ level and post-treatment EOS％were not significantly different between the two groups (P ＞ 0.05);the area under the ROC curve for EOS％ prediction of ICS efficacy before treatment was 0.531 (P ＞0.05),with critical value 3.13％,the sensitivity 57.1％ and specificity 52.4％,respectively.The area under the ROC curve of FeNO for ICS treatment before treatment was 0.628 (P ＜ 0.05),with critical value 30.00％,sensitivity and specificity (64.6％ and 91.0％) respectively.Conclusions For patients with stable COPD,EOS％ and FeNO levels are positively correlated with the improvement of FEV1 after ICS treatment.Both of them can predict the efficacy of ICS to a certain extent,and FeNO has higher predictive value than EOS％,which can be applied to clinical practice.