摘要
目的探讨支气管哮喘-慢性阻塞性肺疾病重叠综合征(ACO)患者血清中纤维蛋白原(Fbg)、呼出气一氧化氮(FeNO)、免疫球蛋白E(IgE)的变化水平与肺功能的相关性。方法选择2016年1月至2018年5月期间在我院接受治疗的支气管哮喘急性发作期患者56例,慢阻肺急性加重期患者51例,ACO急性加重期患者45例,同时选取50例健康者作为对照。检测受试对象的外周血嗜酸性粒细胞数量、Fbg和IgE水平、FeNO以及肺功能指标。采用Pearson相关性分析Fbg、FeNO、IgE与1s用力呼气容积(FEV1),FEV1改善值,用力肺活量(FVC)的关系。绘制受试者工作特征(ROC)曲线,并计算Fbg、FeNO、IgE指标曲线下面积(AUC)。结果①三组患者嗜酸性粒细胞数量和血浆IgE水平明显高于对照组(P<0.05);但是三组患者之间比较,未见统计学差异(P>0.05)。ACO患者血清Fbg水平高于哮喘组患者(P<0.05),FeNO检测值高于慢阻肺患者(P<0.05);②ACO患者FEV1、FEV1改善值和FVC值明显高于对照组和慢阻肺组受试者,但是FEV1值高于哮喘组患者,而FEV1改善值和FVC值低于哮喘组患者(P<0.05);③ACO患者血浆Fbg水平与FEV1、FEV1改善值和FVC值均呈负相关性(P<0.05),而FeNO值仅与FEV1值呈负相关性(P<0.05)。而血浆IgE水平与FEV1改善值呈正负关性(P<0.05);④经ROC曲线分析,Fbg、FeNO、IgE联合检测ROC曲线的AUC为0.892(95%CI:0.773-0.948),敏感性和特异性分别为89%和78%。结论Fbg、FeNO和IgE与ACO患者肺功能指标密切相关,有助于临床鉴别ACO、支气管哮喘以及慢性阻塞性肺疾病。
Objective To investigate the clinical value of levels of fibrinogen (Fbg),procalcitonin (PCT),fractional exhaled nitrie oxide (FeNO) and immunoglobulin E(IgE) in diagnosing bronchial asthma-chronic obstructive pulmonary disease overlap syndrome (ACO) and their relationships with lung functions.Methods A total of 56 patients with asthma,51 patients with chronic obstructive pulmonary disease (COPD) and 45 ACO patients in our hospital from January 2016 to May 2018 were enrolled into this study.At the same time,50 healthy volunteers were selected as the healthy controls.The peripheral eosinophil count,Fbg,FeNO,IgE and lung functions of all the subjects were detected and compared.The relationship between Fbg,FeNO,IgE and the forced expiratory volume in one second (FEV 1),improved FEV 1,forced vital capacity (FVC) was analyzed by Pearson assay.The diagnostic values of Fbg,FeNO,and IgE were analyzed by receiver operating characteristic curve (ROC).Results ①The peripheral eosinophil count and IgE of all the patients were all higher than those of the healthy controls ( P <0.05).However,there was no significant difference among the three experimental groups ( P >0.05).ACO patients had higher Fbg level than the patients with asthma and higher FeNO value than the COPD patients ( P <0.05).②ACO patients had higher FEV 1 value,which was higher than that of the patients with asthma,improved FEV 1 and FVC values,which were lower than those of the other three groups ( P <0.05).③The serum Fbg level of ACO patients was negatively correlated with FEV 1,the improved FEV 1 and FVC ( P <0.05).However,the FeNO value was only negatively correlated with FEV 1 ( P < 0.05).The IgE level was only negatively correlated with the improved FEV 1( P <0.05).④The AUC of Fbg and FeNO combined with IgE in diagnosis of ACO was 0.892 (95% CI : 0.773-0.948).And the sensitivity and specificity were 89.0% and 78.0%,respectively.Conclusion The detection of Fbg,FeNO and IgE as early diagnostic indexes of ACO,which might be related with the lung funct
作者
赵明明
葛林阳
杭燕萍
Zhao Mingming;Ge Linyang;Hang Yanping(Department of Respiratory Medicine,Gaochun people′s Hospital,Nanjing 211300,China)
出处
《中华肺部疾病杂志(电子版)》
CAS
2019年第4期436-440,共5页
Chinese Journal of Lung Diseases(Electronic Edition)
基金
江苏卫生健康职业学院科研项目(JKFY201803)
江苏大学2016年度医学临床科技发展基金(JLY20160193)