摘要
目的评估呼出气一氧化氮（FeNO）在典型哮喘及咳嗽变异性哮喘（CVA）诊断和鉴别中的临床应用价值。方法对苏州大学附属第一医院呼吸内科门诊2013年2月至2014年2月疑诊哮喘患者分别进行肺功能及激发试验检测，根据患者症状及激发试验结果将患者分为典型哮喘组、CVA组、非哮喘组，测量3组患者FeNO值。结果本研究共入组典型哮喘组130例，CVA组80例，非哮喘组92例，典型哮喘组的FeNO值为（78±55）ppb，高于CVA组[（41±18）ppb，P〈0．001]，两者均显著高于非哮喘组[（23±17）ppb，P〈0．001]。两者之间最佳界值为48，曲线下面积为0．746（95％CI0．679～0．812），敏感度为70％，特异度为77．5％。诊断典型哮喘最佳界值为40，曲线下面积为0．888（95％CI0．844～0．931），敏感度为78．5％，特异度为92．4％。诊断CVA最佳界值为33，曲线下面积为0．820（95％CI0．755～0．884），敏感度为82．5％，特异度为72．8％。结论FeNO用于诊断和鉴别典型哮喘及CVA的敏感性和特异性都是可接受的，可以用于两者诊断鉴别的辅助工具。
Objective To assess the clinical differentiation of typical bronchial asthma （asthma） value of exhaled nitric oxide for the diagnosis and and cough variant asthma （CVA）. Methods Newly diagnosed patients were enrolled FeNO, pulmonary function tests, bronchial hyperresponsiveness were compared. We have compared the clinical utilities of FeNO to diagnose and differentiate typical asthma and CVA. Results There were 80 cough variant asthma, 130 typical asthma patients and 92 non asthmatic in our study. FeNO was significantly higher in typical asthma （78±55 ） ppb than in CVA [（41±18） ppb, P 〈 0. 001] and both were significantly higher than non asthmatic patients [（23±17） ppb, P〈0. 001], and in differentiating between the two groups showed a sensitivity of 70% and a specificity of 77.5% at the cutoff value of 48 ppb. The optimal FeNO cutoff value was 40 ppb with a sensitivity of 78.5%, a specificity of 92.4% for the diagnosis of typical asthma and 33 ppb with a sensitivity of 82.5%, a specificity of 72.8% for the diagnosis of CVA. Conclusions FeNO can be used as an additional diagnostic tool for the screening of patients with a suspected diagnosis of asthma.
出处
《国际呼吸杂志》
2015年第20期1541-1544,共4页
International Journal of Respiration
关键词
呼出气一氧化氮
支气管哮喘
咳嗽变异性哮喘
Fractional exhaled nitric oxide
Bronchial asthma
Cough variant asthma
