摘要
背景支气管哮喘是一种气道慢性炎症性疾病,与过敏原密切相关。近年关于下气道呼出气一氧化氮(FeNO)水平与支气管哮喘诊断、分型及患者对吸入激素的反应性关系的文献报道较多,但关于下气道FeNO水平对过敏性哮喘鉴别诊断的报道较少。目的探讨下气道FeNO水平对过敏性哮喘的鉴别诊断价值。方法本研究为回顾性研究。选取2011年6月至2020年6月开滦总医院门诊或住院部收治的支气管哮喘患者850例,将430例过敏性哮喘患者作为A组,420例非过敏性哮喘患者作为B组。另选取本院同期体检健康人群440例作为健康对照组。比较三组下气道FeNO水平及肺功能指标。采用Spearman秩相关分析探讨下气道FeNO水平与过敏性哮喘的相关性。绘制受试者工作特征(ROC)曲线以分析下气道FeNO水平对过敏性哮喘与非过敏性哮喘的鉴别诊断价值。结果A、B组下气道FeNO水平高于健康对照组,用力肺活量(FVC)、用力肺活量占预计值百分比(FVC%)、第1秒用力呼气容积(FEV_(1))、第1秒用力呼气容积占预计值百分比(FEV_(1)%)、第1秒用力呼气容积与用力肺活量比值(FEV_(1)/FVC)、呼气流量峰值(PEF)、呼气流量峰值占预计值百分比(PEF%)、用力呼出25%肺活量时的瞬间流量(FEF_(25))、用力呼出25%肺活量时的瞬间流量占预计值百分比(FEF_(25)%)、用力呼出50%肺活量时的瞬间流量(FEF50)、用力呼出50%肺活量时的瞬间流量占预计值百分比(FEF50%)、用力呼出75%肺活量时的瞬间流量(FEF_(75))、用力呼出75%肺活量时的瞬间流量占预计值百分比(FEF_(75)%)、最大呼气中期流量(MMEF)、最大呼气中期流量占预计值百分比(MMEF%)低于健康对照组(P<0.05);A组下气道FeNO水平高于B组(P<0.05)。Spearman秩相关分析结果显示,下气道FeNO水平与过敏性哮喘呈正相关(r_(s)=0.545,P<0.001)。ROC曲线分析结果显示,下气道FeNO水平鉴别诊断过敏性哮喘与非过敏性
Background Bronchial asthma is a chronic airway inflammatory and allergic disease,which closely related to allergens.In recent years,there were many reports on the effect of fractional exhaled nitric oxide(FeNO)level on the diagnosis and classification of bronchial asthma and the response of patients to inhaled hormones.But there are few reports on the differential diagnostic value of allergic asthma by FeNO level.Objective To discuss the differential diagnostic value of FeNO level in lower airway for allergic asthma.Methods This study is a retrospective study.From June 2011 to June 2020,850 cases of bronchial asthma patients were selected in Outpatient or Inpatient Department in Kailuan General Hospital,in which 430 cases of allergic asthma were taken as group A,420 cases of non-allergic asthma were taken as group B,and 440 people who took normal physical examination in the same period were taken as the healthy control group.FeNO level in lower airway and pulmonary function indexes were compared among the three groups.Spearman rank correlation analysis was used to investigate the correlation between FeNO level in lower airway with allergic asthma.Receiver operating characteristic(ROC)curve was drawn to analyse the differential diagnostic value of FeNO level in lower airway for allergic asthma and non-allergic asthma.Results FeNO level in lower airway in groups A and B was higher than that in healthy control group,forced lung capacity(FVC),percentage of forced lung capacity to estimated value(FVC%),forced expiratory volume in the fir_(s)t second(FEV_(1)),percentage of forced expiratory volume in the first second to estimated value(FEV_(1)%),ratio of forced expiratory volume in the first second to forced lung capacity(FEV_(1)/FVC),peak expiratory flow(PEF),percentage of peak expiratory flow to estimated value(PEF%),forced expiratory flow at 25%forced vital capacity(FEF_(25)),percentage of forced expiratory flow at 25%forced vital capacity to estimated value(FEF_(25)%),forced expiratory flow at 50%forced vital capa
作者
郑丽颖
耿贺梅
刘运秋
汪静
王静
杨晓燕
王丽晔
宋路
ZHENG Liying;GENG Hemei;LIU Yunqiu;WANG Jing;WAGN Jing;YANG Xiaoyan;WANG Liye;SONG Lu(Department of Respiratory and Critical Care Medicine,Kailuan General Hospital,Tangshan 063000,China;Department of Respiratory Medicine,Tangshan Union Medical College Hospital,Tangshan 063000,China;Department of Respiratory Medicine,Tangshan Hongci Hospital,Tangshan 063000,China)
出处
《实用心脑肺血管病杂志》
2021年第9期63-67,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
国家重点研发计划专项课题(2016YFC1303900)
河北省卫计委医学科学研究课题计划项目(20171446)。
关键词
哮喘
过敏性哮喘
非过敏性哮喘
呼出气一氧化氮
诊断
鉴别
Asthma
Allergic asthma
Non-allergic asthma
Fractional exhaled nitric oxide
Diagnosis,differential
