呼出气一氧化氮、总免疫球蛋白E及血嗜酸性粒细胞在儿童哮喘诊断中的价值  

Diagnostic value of FeNO,total IgE and EOS in children with asthma

作　　者：刘开来 LIU Kailai(The First Hospital of Xiangtan,Xiangtan 411101,China)

机构地区：[1]湘潭市第一人民医院儿科,湖南湘潭411101

出　　处：《中国中西医结合儿科学》2023年第3期224-228,共5页Chinese Pediatrics of Integrated Traditional and Western Medicine

摘　　要：目的探究呼出气一氧化氮(FeNO)、总免疫球蛋白E(IgE)、血嗜酸性粒细胞(EOS)应用于儿童哮喘诊断中的价值。方法选取2021年4~10月就诊于湘潭市第一人民医院诊断为支气管哮喘的患儿46例为观察组,同期选择本院就诊的非支气管哮喘儿童41例为对照组。收集两组研究对象的FeNO、总IgE、血常规、肺功能检测结果。比较两组研究对象的FeNO、总IgE、EOS水平和第1秒用力呼气容积占预计值百分比(FEV1%),并进行相关性分析。通过绘制受试者工作曲线(ROC曲线)分析FeNO、总IgE、EOS在儿童哮喘诊断中的效能。结果观察组研究对象FeNO、总IgE、EOS水平均高于对照组,FEV1%低于对照组,差异均有统计学意义(P<0.05)。观察组研究对象的FeNO、总IgE水平与FEV1%呈强负相关,EOS水平与FEV1%呈弱负相关,总IgE水平与FeNO水平呈强正相关(P<0.05),EOS水平与FeNO无相关性(P>0.05)。FeNO、总IgE、EOS诊断儿童哮喘的最佳截断值分别为19.5 ppb、89.1 IU/mL、0.585×10^(9)/L。三者联合诊断儿童哮喘的特异度、敏感度分别为84.8%、87.8%,均高于各指标单一检测的数值。结论FeNO、总IgE、EOS水平升高与儿童哮喘的发生密切相关,三者均可作为儿童哮喘的重要诊断依据,联合检测可提高诊断儿童哮喘的效率及准确性。Objective To explore the value of fractional exhaled nitric oxide(FeNO),total immunoglobulin E(tIgE)and blood eosinophils(EOS)in the diagnosis of asthma in children.Methods A total of 46 children with bronchial asthma,who were diagnosed in the First People′s Hospital of Xiangtan city between April to October 2021,were included in the observation group,and 41 children without bronchial asthma were included in the control group.The results of FeNO,tIgE,blood routine examination and pulmonary function test of the two groups were collected,and the levels of FeNO,tIgE and EOS and FEV1%were compared between the two groups.Correlation analysis was also conducted.The receiver operating characteristic curve(ROC curve)was drawn to analyze the diagnostic efficacy of FeNO,tIgE and EOS for childhood asthma.Results The levels of FeNO,tIgE and EOS in the observation group were significantly higher than those in the control group,while the forced expiratory volume in the first second as a percentage of predicted Value(FEV1%)in the observation group was lower than that in the control group(all P<0.05).In the observation group,FeNO,tIgE,and EOS levels were negatively correlated with FEV1%,while tIgE level was positively correlated with FeNO level(all P<0.05).There was no correlation between EOS level and FeNO(P>0.05).The optimal cut-off values of FeNO,tIgE and EOS for diagnosis of child asthma were 19.5 ppb,89.1 IU/mL,and 0.585×10^(9)/L,respectively.The specificity and sensitivity of the three indexes combined together for diagnosis of asthma in children were 84.8%and 87.8%,respectively,which were higher than the values of each single index.Conclusion The elevated levels of FeNO,tIgE and EOS are closely related to the occurrence of childhood asthma.All of them can be used as important diagnostic indexes for childhood asthma.Combination of the three indexes can improve the efficiency and accuracy of the diagnosis of childhood asthma.

关 键 词：哮喘 呼出气一氧化氮 免疫球蛋白E 嗜酸性粒细胞 儿童 

分 类 号：R725.6[医药卫生—儿科]