血清总IgE和FeNO在哮喘-慢性阻塞性肺疾病重叠综合征患者的表达水平及临床诊断意义  

Study on the expression and diagnostic significance of serum total Ig E and Fe NO in patients with asthma and chronic obstructive pulmonary syndrome

作　　者：陈明勇[1] 吴友茹[1] 朱静[1] 杜蓉[1] 吴君华[1] 袁小玲[1] 

机构地区：[1]绵阳市中心医院呼吸内科,四川绵阳621000

出　　处：《临床和实验医学杂志》2016年第22期2237-2240,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨血清总Ig E和呼出气一氧化氮(Fe NO)在哮喘-慢性阻塞性肺疾病重叠综合征(ACOS)患者的表达水平及临床诊断意义。方法连续性收录38例哮喘患者、40例慢性阻塞性肺疾病患者以及39例ACOS患者以及42例健康人员为研究对象。综合分析比较四组的肺功能、血清总Ig E、Fe NO以及T淋巴细胞因子。结果慢性阻塞性肺疾病组第一秒用力呼气容积(FEV1)、FEV1改善值低于哮喘组、ACOS组,差异有统计学意义(P<0.05),ACOS组FEV%显著低于哮喘组、慢性阻塞性肺疾病组(P<0.05)。慢性阻塞性肺疾病组血清总Ig E、Fe NO、CD4^+、CD4^+/CD8^+显著低于哮喘组、ACOS组(P<0.05)。ACOS组血清Ig E、Fe NO、CD4^+/CD8^+显著低于哮喘组、而CD8^+显著高于哮喘组(P<0.05)。ACOS组、哮喘组Ig E与FEV1改善值、CD4^+、Fe NO显著相关(P<0.05),慢性阻塞性肺疾病组Ig E与FEV%pred、CD4^+、CD8^+显著相关(P<0.05)。ACOS组、哮喘组Fe NO与CD8^+、Ig E显著相关(P<0.05),慢阻肺组Fe NO与CD4^+、CD8^+、CD4^+/CD8^+显著相关(P<0.05)。Fe NO联合Ig E在诊断ACOS时其灵敏度、特异度、诊断准确率以及AUC均显著高于单一指标诊断效能(P<0.05)。结论 Fe NO联合Ig E检测有助于鉴别ACOS、哮喘以及慢性阻塞性肺疾病,从而为临床诊断、治疗及预防依据。Objective To explore the expression and clinical diagnostic significance of serum total IgE and FeNO in patients with asthma and chronic obstructive pulmonary syndrome. Methods A total of 38 patients with asthma and chronic obstructive pulmonary syndrome, 40 patients with chronic obstructive pulmonary syndrome, 39 patients with ACOS and 42 healthy persons were consecutively included in this study. Their lung function, serum total IgE, FeNO and T lymphocyte factors in these 4 groups were examined and compared. Results FEV1 and improved FEV1 value in patients of COPD group were lower than those of patients in asthma group and ACOS group, their difference was statistically significant （ P 〈0.05 ）, FEV% pred in ACOS group was significantly lower than that of asthma group and COPD group （ P 〈0.05 ）. The serum total IgE and FeNO, CD4^＋ , CD4^＋/CD8^＋ in COPD group were significantly lower than those of asthma group and ACOS group （ P 〈 0.05 ）. Serum total IgE, FeNO, CD4 ^＋ and/CD8^＋ in ACOS group were significantly lower than those of asthma group, and CD8^＋ was significantly higher than that of asthma group （ P 〈 0. 05 ）. serum IgE, improved value of FEV1, CD4^＋ and FeNO in ACOS group and asthma group were significantly correlated （ P 〈0.05）, serum IgE, FEV% pred, CD4^＋ and CD8^＋ were significantly correlated in COPD group （ P 〈 0. 05 ）. FeNO and CD8 ~ , IgE were significantly correlated in ACOS group and asthma group （ P 〈 0.05 ）, FeNO, CD4^＋ , CD8 ^＋ and CD4^＋/CD8^＋ in COPD group were significantly correlated （ P 〈 0.05 ）. The sensitivity, specificity, accuracy and AUC of FeNO combined with IgE in diagnosis of ACOS were significantly higher than those of diagnostic efficiency with single index （ P 〈 0. 05 ）. Conclusion The joint examination of FeNO and IgE is helpful in identification of ACOS, asthma and chronic obstructive pulmonary disease, thus it is helpful in clinical diagnosis, treatment and prevention, hence it may provide a theore

关 键 词：哮喘-慢性阻塞性肺疾病重叠综合征 IgE 呼出气一氧化氮 

分 类 号：R563.9[医药卫生—呼吸系统] R562.25[医药卫生—内科学]