临床控制哮喘与咳嗽变异性哮喘的小气道功能及FeNO变化差异分析  

Analysis of the Differences in Small Airway Function and FeNO Changes between Clinical Control of Asthma and Cough-variant Asthma

作　　者：许圣威 陈玲玲 曹晓红 陈志嘉 XU Shengwei;CHEN Lingling;CAO Xiaohong;CHEN Zhijia(Department of Respiratory and Critical Care Medicine,Xiamen Haicang Hospital,Xiamen 361026,China;不详)

机构地区：[1]厦门市海沧医院呼吸与危重症医学科,福建厦门361026

出　　处：《中国医学创新》2024年第25期161-165,共5页Medical Innovation of China

摘　　要：目的:探究临床控制哮喘(CCA)与咳嗽变异性哮喘(CVA)的小气道功能及呼出气一氧化氮(FeNO)变化差异,并分析各指标对CCA与CVA的鉴别诊断价值。方法:选取2021年1月—2023年12月厦门市海沧医院的51例CCA与51例CVA患者的病历资料进行回顾性分析,比较两组肺通气功能指标[用力肺活量占预计值百分比(FVC%pred)、第1秒用力呼气量占预计值百分比(FEV1%pred)、呼气峰值流量占预计值百分比(PEF%pred)]、小气道功能指标[中段呼气流量占预计值百分比(FEF_(25%~75%)%pred)、75%和50%用力肺活量时的呼吸流速占预计值百分比(FEF_(75%)%pred和FEF_(50%)%pred)]及FeNO,采用Pearson相关性分析各组FeNO与气道功能指标的关系,采用受试者操作特征(ROC)曲线分析FeNO与小气道功能指标对CVA的诊断价值。结果:与CCA组比较,CVA组FEV_(1)%pred、PEF%pred、FEF_(25%~75%)%pred、FEF_(50%)%pred、FEF_(75%)%pred均较低,FeNO指标较高,差异均有统计学意义(P<0.05)。Pearson相关性结果显示,CCA组与CVA组气道功能指标与FeNO指标均呈负相关(P<0.05)。ROC曲线结果显示,FEF_(25%~75%)%pred、FEF_(50%)%pred、FEF_(75%)%pred和FeNO诊断CVA的AUC分别为0.824、0.836、0.790、0.793,均有一定的诊断价值(P<0.001),但各指标之间AUC值比较差异均无统计学意义(P>0.05)。结论:相较于CCA患者,CVA患者的小气道功能较差,FeNO较高,且FEF_(25%~75%)%pred、FEF_(50%)%pred、FEF_(75%)%pred和FeNO对CVA有一定的诊断价值。Objective:To explore the differences in small airway function and fractional exhaled nitric oxide(FeNO)changes between clinically controlled asthma(CCA)and cough-variant asthma(CVA),and to analyze the value of different indexes in the diagnosis of CVA.Method:A retrospective analysis was performed on the case data of 51 patients with CCA and 51 patients with CVA in Xiamen Haicang Hospital between January 2021 and December 2023.The pulmonary ventilation function index[forced vital capacity as a percentage of predicted value(FVC%pred),forced expiratory volume in the first second as a percentage of predicted value(FEV_(1)%pred),peak expiratory flow as a percentage of predicted value(PEF%pred)],small airway function indexes[forced expiratory flow at 25%-75%of vital capacity as a percentage of predicted value(FEF_(25%-75%)%pred),forced expiratory flow after 50%of vital capacity as a percentage of predicted value(FEF50%%pred),forced expiratory flow after 75%of vital capacity as a percentage of predicted value(FEF_(75%)%pred)]and FeNO were compared between two groups.The relationship between FeNO and airway function indexes was analyzed by Pearson correlation analysis.The value of FeNO and small airway function indexes in the diagnosis of CVA was analyzed by receiver operating characteristic(ROC)curves.Result:Compared with CCA group,FEV_(1)%pred,PEF%pred,FEF_(25%-75%)%pred、FEF_(50%)%pred、FEF_(75%)%pred were lower,while FeNO was higher in CVA group(P<0.05).The results of Pearson correlation analysis showed that airway function indexes were negatively correlated with FeNO(P<0.05).The results of ROC curves analysis showed that AUC values of FEF_(25%-75%)%pred、FEF_(50%)%pred、FEF_(75%)%pred and FeNO in the diagnosis of CVA were 0.824,0.836,0.790 and 0.793,all showing certain diagnosis value(P<0.001),but there was no significant difference in AUC among all indexes(P>0.05).Conclusion:Compared with CCA patients,small airway function is worse,and FeNO is higher in CVA patients.FEF_(25%-75%)%pred,FEF_(50%)%pred,FEF_(75%)%p

关 键 词：小气道功能 呼出气一氧化氮 临床控制哮喘 咳嗽变异性哮喘 

分 类 号：R562.25[医药卫生—呼吸系统]