呼出气一氧化氮检测对支气管哮喘患者的诊断及预后评估价值分析  

Analysis of Diagnostic and Prognostic Value of Exhaled Nitric Oxide in Patients with Bronchial Asthma

作　　者：黄拔威[1] 许能銮[2] 

机构地区：[1]福建医科大学省立临床医学院福建省立金山医院内科,福建福州350001 [2]福建医科大学省立临床医学院福建省立医院呼吸内科,福建福州350001

出　　处：《中外医疗》2017年第25期38-40,共3页China & Foreign Medical Treatment

摘　　要：目的探究呼出气一氧化氮(FeNO)检测对支气管哮喘患者的诊断及预后评估价值。方法研究对象方便选取为2015年1月—2017年3月之间该院收治的104例支气管哮喘患者,设为观察组,选取同期的100名健康体检者作为对照组,对比两组受检者的肺功能情况及FeNO水平,观察组采用特布他林雾化吸入治疗,连续治疗2周,对比治疗前后观察组的肺功能及FeNO水平变化情况。结果观察组的最大呼气流量占比(PEF)、1 s用力呼气末容积占比(FEV1)、用力肺活量占比(FVC)均显著低于对照组,FeNO水平显著高于对照组,差异有统计学意义(P<0.05);观察组治疗前PEF、FEV1、FVC、FeNO分别为(77.9±11.4)%、(83.7±9.2)%、(93.6±3.1)%、(74.9±13.6)μg/L,治疗后分别为(80.4±9.6)%、(92.3±4.6)%、(95.0±3.7)%、(47.5±12.6)μg/L,治疗后观察组患者的PEF、FVC与治疗前相比差异无统计学意义(P>0.05),FEV1显著高于治疗前,FeNO显著低于治疗前,差异有统计学意义(P<0.05);ROC曲线显示FeNO诊断支气管哮喘的最佳截点为45.9μg/L,曲线下面积为0.853(95%CI为0.761~0.945),在此截点下诊断灵敏度为70.4%,特异度为93.5%。结论呼出气一氧化氮检测在支气管哮喘患者的诊断中有着较好的灵敏度和特异度,且能够反映患者的预后情况,值得在临床上推广和应用。Objective This paper tries to explore the diagnostic and prognostic value of exhaled nitric oxide(FeNO) in patients with bronchial asthma. Methods A total of 104 patients with bronchial asthma enrolled in the hospital from January2015 to March 2017 were selected as the observation group, and 100 healthy subjects were conveniently selected as the control group. The levels of pulmonary function and FeNO in the two groups were compared. The observation group adopted terbutaline nebulization treatment for two weeks and the pulmonary function and FeNO level after treatment were compared with those before treatment. Results The levels of PEF, FEV1, FVC in the observation group were lower than those in the control group, while the FeNO level was higher than the control group, and the difference was statistically significant(P<0.05); the levels of PEF, FEV1, FVC and FeNO in the observation group before treatment were(77.9 ±11.4)%,(83.7 ±9.2)%,(93.6±3.1)%,(74.9±13.6)μg/L, and those after treatment were(80.4±9.6)%,(92.3±4.6)%,(95.0±3.7)%,(47.5±12.6)μg/L, the PEF and FVC in the observation group after treatment were not significantly different from those before treatment(P>0.05); the FEV1 was significant higher than that before treatment, and FeNO was lower than that before treatment, and the difference was significant(P<0.05); The ROC curve showed that the optimal cutoff point for bronchial asthma was 45.9 ug/L and the area under the curve was 0.853(95% of CI was between 0.761 and 0.945). The diagnostic sensitivity was 70.4% and the specificity was 93.5%. Conclusion Exhaled nitric oxide(NOS) has good sensitivity and specificity in the diagnosis of bronchial asthma, and it can reflect the prognosis of patients. It is worthy to be popularized and applied in clinical practice.

关 键 词：支气管哮喘 呼出气一氧化氮 诊断 预后 

分 类 号：R443[医药卫生—诊断学]