肺泡气一氧化氮、血清S100A4、LXA4在成人支气管哮喘中的诊断价值  

Diagnostic value of alveolar nitric oxide,serum S100A4,LXA4 in adult patients with bronchial asthma

作　　者：冯敏娟 安太 闫海花 路海荣 FENG Minjuan;AN Tai;Yan Haihua;LU Hairong(Department of Respiratory and Critical Care Medicine,Xianyang Hospital of Yan′an University,Xianyang,Shaanxi 712000,China;Department of Medical Laboratory,Xianyang Caihong Hospital,Xianyang,Shaanxi 712021,China)

机构地区：[1]延安大学咸阳医院呼吸与危重症医学科,陕西咸阳712000 [2]咸阳彩虹医院医学检验科,陕西咸阳712021

出　　处：《检验医学与临床》2023年第10期1354-1357,共4页Laboratory Medicine and Clinic

基　　金：国家卫生和计划生育委员会医药卫生科技发展研究中心课题(W2019ZT583)。

摘　　要：目的分析肺泡气一氧化氮(CaNO)及血清S100钙结合蛋白4(S100A4)、脂氧素A4(LXA4)水平与成人支气管哮喘患者肺功能的相关性及其联合检测对成人支气管哮喘的诊断价值。方法选择延安大学咸阳医院2019年1月至2022年1月收治的92例成人疑似支气管哮喘患者为研究对象。对所有患者均开展CaNO及肺功能检查,并检测血清S100A4、LXA4水平。以支气管舒张试验阳性作为哮喘诊断的金标准,将患者分为哮喘组和非哮喘组,比较哮喘组和非哮喘组的CaNO、S100A4、LXA4水平及肺功能指标。以Pearson相关分析明确CaNO、S100A4、LXA4水平与肺功能指标的相关性。采用受试者工作特征(ROC)曲线分析CaNO、S100A4、LXA4联合检测诊断支气管哮喘的效能。结果支气管舒张试验阳性45例,阴性47例,故哮喘组人数45例,非哮喘组人数47例。哮喘组CaNO、S100A4、LXA4水平分别为(9.25±2.71)ppb、(247.59±22.18)ng/L、(93.15±7.54)ng/L,高于非哮喘组的(5.37±1.06)ppb、(153.77±12.68)ng/L、(72.04±6.81)ng/L,差异有统计学意义(P<0.05)。哮喘组治疗前1秒用力肺呼气容积(FEV1)与预计值比值(FEV1%)、用力肺活量(FVC)与预计值比值(FVC%)及FEV1/FVC分别为(65.21±6.21)%、(72.04±5.84)%、70.51±10.48,低于非哮喘组的(93.79±10.38)%、(90.57±6.10)%、86.65±11.56,差异有统计学意义(P<0.05),且哮喘组治疗后FEV1%、FVC%及FEV1/FVC高于治疗前,差异有统计学意义(P<0.05)。CaNO、S100A4、LXA4水平与FEV1%、FVC%、FEV1/FVC均呈负相关(P<0.05)。CaNO、S100A4、LXA4联合检测诊断支气管哮喘的效能优于上述3项指标单独检测。结论CaNO及血清S100A4、LXA4联合检测诊断支气管哮喘的效能较好,且3项指标水平均与患者肺功能指标呈负相关。Objective To explore the correlations between alveolar nitric oxide(CaNO),serum S100 calcium binding protein 4(S100A4),lipoxylate A4(LXA4)and lung function in adult patients with bronchial asthma and the diagnostic value of their combined detection.Methods A total of 92 adult patients with suspected bronchial asthma who were admitted to Xianyang Hospital of Yan′an University from January 2019 to January 2022 were selected.All patients were examined for CaNO and lung function indexes,serum S100A4 and LXA4 levels were detected.Taking the positive bronchodilation test as the gold standard for the diagnosis of asthma,the patients were divided into asthma group and non-asthma group.The CaNO,S100A4,LXA4 levels and lung function indexes in the asthma group and non-asthma group were compared.Pearson correlation analysis was used to determine the correlations between CaNO,S100A4,LXA4 levels and lung function indexes.The efficacy of combined detection of CaNO,S100A4,and LXA4 levels in the diagnosis of bronchial asthma was analyzed by the receiver operating characteristic(ROC)curve.Results The results of bronchial dilation test showed that 45 cases were positive and 47 cases were negative,so there were 45 cases in the asthma group and 47 cases in the non-asthma group.The CaNO,S100A4 and LXA4 levels in the asthma group were(9.25±2.71)ppb,(247.59±22.18)ng/L and(93.15±7.54)ng/L respectively,which were higher than those in the non-asthma group[(5.37±1.06)ppb,(153.77±12.68)ng/L and(72.04±6.81)ng/L,all P<0.05].The ratio of forced expiratory volume(FEV1)to predicted value(FEV1%),forced vital capacity(FVC%)to predicted value(FVC%)and FEV1/FVC in the asthma group before treatment were(65.21±6.21)%,(72.04±5.84)%,70.51±10.48 respectively,which were lower than those in the non-asthma group[(93.79±10.38)%,(90.57±6.10)%,86.65±11.56,all P<0.05].In addition,FEV1%,FVC%and FEV1/FVC in the asthma group after treatment were significantly higher than those in the non-asthma group(all P<0.05).The CaNO,S100A4 and LXA4 levels correla

关 键 词：支气管哮喘 肺泡气一氧化氮 S100钙结合蛋白4 脂氧素A4 肺功能 

分 类 号：R562.25[医药卫生—呼吸系统]