FeNO联合血清ECP、IgE检测对支气管哮喘的临床诊断价值  

Clinical value of FeNO combined with serum ECP and IgE in the diagnosis of bronchial asthma

作　　者：买智涛[1] 姜明明[1] 万善志 MAI Zhitao;JIANG Mingming;WAN Shanzhi(Respiratory medicine department one,Cangzhou central hospital,Cangzhou,Hebei,China,061001)

机构地区：[1]沧州市中心医院呼吸内一科,河北沧州061001

出　　处：《分子诊断与治疗杂志》2020年第5期625-628,633,共5页Journal of Molecular Diagnostics and Therapy

基　　金：沧州市科技计划项目(1832131440)。

摘　　要：目的探讨呼出气一氧化氮(FeNO)、血清嗜酸性粒细胞阳离子蛋白(ECP)、免疫球蛋白E(IgE)单项及联合检测对支气管哮喘的诊断效能,以及各指标与肺功能的关系。方法选取2016年6月至2018年6月在本院接受治疗的138例疑似支气管哮喘患者为研究对象,对比分析最终诊断为支气管哮喘及非支气管哮喘(如慢性支气管炎等)患者的基线资料、FeNO、血清ECP、IgE水平及肺功能的差异,同时分析FeNO、血清ECP、IgE水平与肺功能的关系,并绘制FeNO、血清ECP、IgE单独及联合检测鉴别诊断支气管哮喘的ROC曲线。结果138例疑似支气管哮喘患者中,最终诊断为支气管哮喘者67例;非支气管哮喘者71例,其中23例为慢性咳嗽,14例为慢性支气管炎,18例为过敏性鼻炎,其他为16例。支气管哮喘组患者FeNO、血清ECP、IgE水平均明显高于非支气管哮喘组(P<0.05),而FEV1%、PEF%水平明显低于非支气管哮喘组(P<0.05)。FeNO、血清ECP、IgE水平与FEV1%、PEF%指标均呈显著负相关(P<0.05)。ROC曲线结果示,3指标联合检测诊断支气管哮喘的AUC为0.847,高于各指标的单项检测(0.834、0.780、0.730),且检测敏感度为0.731,显著高于各指标单项检测(0.642、0.597、0.493)。结论支气管哮喘患者存在FeNO、血清ECP、IgE的显著升高,且与机体FEV1%、PEF%等肺功能指标呈显著的线性负相关。对于疑似支气管哮喘患者,早期进行FeNO、血清ECP、IgE检测有利于支气管哮喘的鉴别诊断,而联合检测对支气管哮喘具有更高的敏感度,对支气管哮喘的早期筛查更具价值。Objective To investigate the diagnostic efficacy of FeNO,serum ECP and IgE for bronchial asthma,and the relationship between these indexes and lung function.Methods 138 patients suspected of having bronchial asthma who were treated in our hospital from June 2016 to June 2018 were enrolled as research objects.The differences in baseline data,FeNO,serum ECP,IgE,and pulmonary function between patients with bronchial asthma and non⁃bronchial asthma(e.g.chronic bronchitis)were compared.The relationship between FeNO,serum ECP and IgE levels and lung function was also analyzed.The ROC curve of FeNO,serum ECP,IgE was calculated for the diagnosis of bronchial asthma.Results Among 138 patients suspected of having bronchial asthma,67 cases were diagnosed as bronchial asthma.Among the 71 cases of non⁃bronchial asthma,23 cases had chronic cough,14 cases had chronic bronchitis,18 cases were allergic rhinitis,and the others were 16 cases.The levels of FeNO,serum ECP and IgE in the bronchial asthma group were significantly higher than those in the non⁃bronchial asthma group(P<0.05).The levels of FEV1%and PEF%in the bronchial asthma group were significantly lower than those in non⁃bronchial asthma group(P<0.05).FeNO,serum ECP,IgE levels were negatively correlated with FEV1%and PEF%(P<0.05).The results of the ROC curve showed that the AUC of the combined detection of three indicators for the diagnosis of bronchial asthma was 0.847,it was higher than that of the single detection of each indicator(0.834,0.780,0.730)with the sensitivity of 0.731,significantly higher than that of the single detection of each indicator(0.642,0.597,0.493).Conclusion In patients with bronchial hypertension,there is a significant increase in FeNO,serum ECP,and IgE,and negatively correlated with lung function indexes such as FEV1%and PEF%.For patients suspected of having bronchial asthma,FeNO,serum ECP and IgE detection in early stage is beneficial to the differential diagnosis of bronchial asthma,Notably,the combined detection has a higher sensiti

关 键 词：呼出气一氧化氮 嗜酸性粒细胞阳离子蛋白 免疫球蛋白E 支气管哮喘 诊断 

分 类 号：R562.25[医药卫生—呼吸系统] R446.6[医药卫生—内科学]