摘要
目的探讨呼出气一氧化氮(FeNO)在儿童急性呼吸道感染中的诊断价值。方法选取延安大学附属医院及延安医疗集团洛川分院儿科2019年3月至2020年5月收治的171例急性呼吸道感染患儿为病例组,包括90例急性上呼吸道感染(急性上呼吸道感染组)和81例急性感染性肺炎(急性感染性肺炎组)。另随机选取延安大学附属医院48例普外科门诊确诊为疝气并择期进行手术治疗的患儿为对照组。病例组在入院后在24 h内进行FeNO检测,对照组在行疝气手术前行FeNO检测。比较各组的FeNO,并分析FeNO与呼吸道不同部位急性感染的相关性及FeNO诊断急性呼吸道感染部位的准确性。结果急性感染性肺炎组的FeNO为(27.27±7.99)ppb,明显高于急性上呼吸道组的(15.56±6.15)ppb及对照组的(14.00±5.75)ppb,差异具有统计学意义(P<0.001),而急性上呼吸道感染组与对照组的FeNO比较,差异无统计学意义(P>0.05)。FeNO与儿童急性呼吸道感染炎性病灶部位的深度呈正相关(r=0.62,P<0.05)。ROC曲线显示,FeNO用于诊断儿童急性感染性肺炎的最佳临界值是10.5 ppb,曲线下最大面积为0.677(95%CI:0.598~0.757),诊断急性感染性肺炎的灵敏度和特异度分别为88.9%、43.3%。结论急性感染性肺炎儿童的FeNO较急性上呼吸道感染及无呼吸道感染儿童明显升高,检测FeNO有助于儿童急性感染性肺炎诊断准确性的提高及治疗方法的选择。
Objective To explore the diagnostic value of fractional exhaled nitric oxide(FeNO)in children with acute respiratory tract infection.Methods A total of 171 children with acute respiratory tract infection treated in the pediatrics department of Yan'an university affiliated hospital and Luochuan branch of Yan'an medical group from March 2019 to May 2020 were selected as case group,including 90 cases of acute upper respiratory tract infection(acute upper respiratory tract infection group)and 81 cases of acute infectious pneumonia(acute infectious pneumonia group).In addition,48 children who were diagnosed as hernia in the general surgery clinic of the Yan'an university affiliated hospital and underwent elective surgery were randomly selected as control group.FeNO test was performed in the case group within 24 h after admission,and FeNO test was performed in the control group before hernia surgery.FeNO in each group was compared,the correlation between FeNO and acute respiratory tract infection in different parts,the accuracy of FeNO in diagnosing acute respiratory tract infection sites were analyzed.Results FeNO in the acute infectious pneumonia group was(27.27±7.99)ppb,which were significantly higher than(15.56±6.15)ppb in the acute upper respiratory tract infection group and(14.00±5.75)ppb in the control group,the differences were statistically significant(P<0.001),but there was no significant difference in FeNO between the acute upper respiratory tract infection group and the control group(P>0.05).FeNO was positively correlated with the depth of inflammatory lesions in children with acute respiratory tract infection(r=0.62,P<0.05).ROC curve showed that the best critical value of FeNO for the diagnosis of acute infectious pneumonia in children was 10.5 ppb,the maximum area under the curve was 0.677(95%CI:0.598-0.757),and the sensitivity and specificity for the diagnosis of acute infectious pneumonia were 88.9%and 43.3%respectively.Conclusion FeNO in children with acute infectious pneumonia is significantly high
作者
宋建刚
梁小延
姜华
庞随军
李元霞
SONG Jiangang;LIANG Xiaoyan;JIANG Hua;PANG Suijun;LI Yuanxia(No.1 Ward of Pediatrics Department,Yan'an University Affiliated Hospital,Yan'an 716000;Pediatrics Department,Luochuan Branch,Yan'an Medical Group,Yan'an 727400,China)
出处
《临床医学研究与实践》
2021年第35期34-36,共3页
Clinical Research and Practice
基金
陕西省卫生健康科研基金项目(No.2018D081)。
关键词
儿童
呼出气一氧化氮
呼吸道
肺炎
急性感染
children
fractional exhaled nitric oxide
respiratory tract
pneumonia
acute infection
