呼出气一氧化氮与血清炎症因子辅助诊断成人哮喘的临床价值  

The clinical value of exhaled nitric oxide and serum inflammatory factors in assisting the diagnosis of adult asthma

作　　者：张文静 Zhang Wenjing(Tianjin Huaxing Hospital,Tianjin 300270,China)

机构地区：[1]天津华兴医院,天津300270

出　　处：《首都食品与医药》2024年第19期39-42,共4页Capital Food Medicine

摘　　要：目的探讨呼出气一氧化氮(FeNO)与血清炎症因子辅助诊断成人哮喘的临床价值。方法选取2021年8月-2024年1月天津华兴医院确诊的急性发作期支气管哮喘(Acute exacerbation of bronchial asthma,AEBA)患者38例和急性发作期慢性阻塞性肺疾病(Acute phase chronic obstructive pulmonary disease,ACOPD)患者41例为研究对象。分别采用NIOX MINO一氧化氮测定仪和酶联免疫吸附(Enzyme-linked immunosorbent assay,ELISA)法检测两组患者FeNO及血清白介素1β(IL-1β)和白介素9(IL-9)水平;同时检测两组患者肺功能指标,并比较上述指标在两组患者间是否存在差异。采用贝叶斯定理计算上述指标辅助诊断成人哮喘的临床价值,并计算诊断的敏感性、特异性及受试者工作特征曲线(Receiver Operating Characteristic,ROC)。结果AEBA与ACOPD两组患者年龄、性别比例、身高、体重和BMI等方面差异无统计学意义,具有可比性(P>0.05);AEBA组患者FeNO、血清IL-1β、IL-9和肺功能FEV1%、FEV1/FVC%均显著高于ACOPD患者,且差异有统计学意义(P<0.05);以FeNO、血清IL-1β、IL-9和FEV1%、FEV1/FVC%为参考,诊断AEBA的敏感性分别为0.93、0.88、0.90、0.80和0.71;特异性分别为0.82、0.81、0.71、0.89和0.87;ROC曲线下面积分别为0.89、0.88、0.93、0.86和0.84。结论FeNO和血清炎症因子IL-1β、IL-9在成人哮喘患者中显著增高并可作为辅助诊断哮喘的重要参考指标。Objective To explore the clinical value FeNO and serum inflammatory factors for diagnosis of adult asthma.Methods 38 patients with acute exacerbation of bronchial asthma(AEBA)and 41 patients with acute phase chronic obstructive pulmonary disease(ACOPD)diagnosed at Tianjin Huaxing Hospital from August 2021 to January 2024 were selected as the study subjects.The NIOX MINO nitric oxide analyzer and enzyme-linked immunosorbent assay(ELISA)were used to detect FeNO and serum interleukin-1β(IL-1β),and levels of interleukin-9(IL-9)in two groups of patients;simultaneously test the lung function indicators of two groups of patients and compare whether difference of two groups.Using Bayesian theorem to calculate the clinical value of the above indicators in assisting the diagnosis of adult asthma,and calculating the sensitivity,specificity,and ROC of the diagnosis.Results None statistically significant difference in age,gender ratio,height,weight,and BMI between the AEBA and ACOPD groups,and they were comparable(P>0.05);FeNO and serum IL-1βin AEBA group patients,IL-9 and lung function FEV1%,FEV1/FVC%were significantly higher in ACOPD patients(P<0.05);the sensitivity of diagnosing AEBA using FeNO,serum IL-1,IL-9 and FEV1%,FEV1/FVC%as references,was 0.93,0.88,0.90,0.80,and 0.71,respectively;the specificity is 0.82,0.81,0.71,0.89,and 0.87,respectively;AUC are 0.89,0.88,0.93,0.86,and 0.84,respectively.Conclusion FeNO and serum inflammatory cytokine IL-1β,IL-9 levels are significantly elevated in adult asthma patients and can serve as an important reference indicator for assisting in the diagnosis of asthma.

关 键 词：呼出气一氧化氮 血清炎症因子 成人哮喘 鉴别诊断 

分 类 号：R562.25[医药卫生—呼吸系统]