呼出气一氧化氮浓度测定在不同控制程度支气管哮喘患者中的差异  

Measurement of fractional exhaled nitric oxide in asthmatics under different control statuses

作　　者：关伟杰[1,2,3] 郑劲平[1,2,3] 蒋才玉[1,2,3] 谢燕清[1,2,3] 安嘉颖[1,2,3] 虞欣欣[1,2,3] 刘文婷[1,2,3] 高怡[1,2,3] 

机构地区：[1]呼吸疾病国家重点实验室(广州医学院) [2]广州医学院第一附属医院 [3]广州呼吸疾病研究所,510120

出　　处：《中华哮喘杂志（电子版）》2012年第2期1-5,共5页Chinese Journal of Asthma(Electronic Version)

摘　　要：目的比较呼出气一氧化氮(FeNO)浓度测定在不同控制状态支气管哮喘(简称哮喘)FeNO患者中的差异。方法使用瑞典Aerocrine NIOX MINO测试仪对83例受试者(20例未控制、22例部分控制、20例完全控制哮喘患者和21名正常受试者)进行FeNO浓度测定,分析各组数据的分布特点以及与AQLQ哮喘症状评分的相关关系,并通过受试者工作特征图探讨对不同哮喘控制状态气道炎症增高的识别能力。结果未控制组与部分控制组(26.0～49.0)区间的比例(分别为40.0%与40.9%)高于完全控制组(25.0%),但差异无统计学意义(χ2=1.421,P=0.491),未控制组个体间差异最大。部分控制组(41.0ppb)与未控制组的中位数(45.5ppb)相近,完全控制组(57.5ppb)最大,但三组间差异无统计学意义(χ2=0.971,P=0.615)。FeNO与AQLQ哮喘症状评分之间不存在相关关系(r=-0.084,P>0.05)。FeNO测定对不同哮喘控制状态增高的气道炎症识别能力相当(AUC>0.75,P<0.05),对未控制与部分控制患者识别能力稍优于完全控制患者。结论哮喘控制状态与FeNO不平行,FeNO测定对不同哮喘控制状态气道炎症的识别能力接近,但不能作为判断控制状态的单独依据。Objective To compare the distinction in fractional exhaled nitric oxide（FeNO） in asthmatics under different control statuses.Methods Measurements of FeNO were performed in 20 uncontrolled,22 partly controlled and 20 controlled asthmatics and 21 normal controls using a portable NIOX MINO detector（Aerocrine Co.Ltd.,Sweden）.The distribution character of FeNO in each group was analyzed,and the correlation with AQLQ asthma symptom score was determined.The discriminative power to enhanced airway inflammation was compared using receiver operation characteristic curve.Results The proportion of FeNO between 26.0 ppb and 49.0 ppb was larger in uncontrolled（40.0%） and partly controlled（40.9%） asthmatics as compared with that of controlled asthmatics（25.0%）,though no statistical difference（χ2=1.421,P=0.491） was found.Interpersonal variation was highest in uncontrolled asthmatics.The median of partly controlled group（41.0 ppb） resembled that of uncontrolled group（45.5 ppb）,both of which were lower than that of controlled group（57.5 ppb）,with no statistical significance（χ2=0.971,P=0.615） shown in their difference.No correlation（r=-0.084,P0.05） between overall level of FeNO and AQLQ asthma symptom score was revealed.Measurement of FeNO had discriminative power to asthmatics under various control statuses（AUC0.75,P0.05） as reflected by receiver operation characteristic curves,with minor superiority in uncontrolled and partly controlled asthmatics.Conclusions FeNO is unparallel to asthma control.Measurement of FeNO is of discriminative power to enhanced airway inflammation in asthmatics under different control statuses,despite that it could not be regarded as the single predictor of asthma control.

关 键 词：呼出气一氧化氮 支气管哮喘 哮喘控制状态 诊断价值 

分 类 号：R562.25[医药卫生—呼吸系统]