FeNO、外周血EOS、血清IgE与肺功能联合检查对儿童支气管哮喘合并过敏性鼻炎的预测价值  

FeNO,peripheral blood EOS,and serum IgE inflammation⁃related indices in asthma combined with allergic rhinitis in children

作　　者：陈露萍 马文娟 杨轶童 赵苗苗 孙媛[2] 孙珠君 石曌玲 CHEN Luping;MA Wenjuan;YANG Yitong;ZHAO Miaomiao;SUN Yuan;SUN Zhujun;SHI Zhaoling(The First Clinical Medical College,Shaanxi University of Chinese Medicine,Xianyang,Shaanxi 712046,China;The Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang,Shaanxi 712000,China)

机构地区：[1]陕西中医药大学第一临床医学院,陕西咸阳712046 [2]陕西中医药大学第二附属医院儿童呼吸哮喘科,陕西咸阳712000

出　　处：《热带医学杂志》2025年第1期85-89,I0003,共6页Journal of Tropical Medicine

基　　金：陕西省卫健委自然科学基金(82205188);咸阳市科技局(2021ZDYF-SF-0043)。

摘　　要：目的探讨呼出气一氧化氮(FeNO)、外周血嗜酸性粒细胞(EOS)及血清免疫球蛋白E(IgE)与肺功能联合检查对儿童哮喘合并过敏性鼻炎的预测价值,为哮喘(AS)和过敏性鼻炎(AR)的防治提供参考依据。方法选取2022年3-12月陕西中医药大学第二附属医院122例诊断为AS的患儿为观察组,按照是否合并AR分为AS+AR组(n=65)和AS组(n=57),并选取52名健康儿童作为对照组。比较3组FeNO、外周血EOS、血清IgE、肺功能水平及过敏原检测结果。使用受试者工作特性(ROC)曲线分析FeNO、外周血EOS、总IgE及肺功能[第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占用力肺活量百分比(FEV1/FVC)]联合诊断AS+AR的效能。结果AS+AR组患儿FeNO、EOS、总IgE值明显高于AS组和对照组,差异均有统计学意义(F=195.491、71.349、57.344,P均<0.05)。AS+AR组过敏原阳性率高于AS组和对照组,其中交链孢霉、艾蒿、粉尘螨、普通豚草、屋尘螨的阳性率较高,3组比较差异有统计学意义(χ^(2)=54.00、58.00、42.00、46.87、32.00,P均<0.05)。FeNO值与总IgE成正相关关系(r=0.5275,P<0.05)。ROC曲线提示,FeNO、EOS、总IgE及肺功能检测联合诊断AS+AR的价值大于单一指标检测,FeNO诊断AS+AR的最佳阈值为38.34 ppb。结论哮喘合并过敏性患儿FeNO、外周血EOS、血清IgE水平较单独哮喘的患儿升高,联合肺功能检测可提高临床诊断效能。Objective To explore the predictive value of exhaled breath nitric oxide(FeNO),peripheral blood eosinophil(EOS)and serum immunoglobulin E(IgE)and lung function test in childhood asthma with allergic rhinitis,and provide reference for the prevention and treatment of asthma(AS)and allergic rhinitis(AR).Methods A total of 122 children diagnosed with AS in the Second Affiliated Hospital of Shaanxi University of Chinese Medicine from March to December 2022 were selected as the observation group,divided into AS+AR group(n=65)and AS group(n=57)according to whether the AR was combined,and 52 healthy children were selected as the control group.Three groups were compared with FeNO,peripheral blood EOS,serum IgE,pulmonary function levels,and allergen test results.The predictive values of FeNO,peripheral blood EOS,total IgE,and pulmonary function[the first second expiratory volume with exertion(FEV1),the first second expiratory volume with exertion as a percentage of expiratory lung capacity with exertion(FEV1/FVC)]in the combined diagnosis of AS+AR was analyzed using receiver operating characteristics(ROC)curves.Results The values of FeNO,EOS and total IgE in the AS+AR group were significantly higher than those in the AS group and the control group(F=195.491,71.349,57.344;all P<0.05);The positive rate of allergens in the AS+AR group was higher than that in the AS group and the control group,and the positive rates of Alternaria,Artemisia annua,dust mite,common ragweed and house dust mite were higher,and the difference between the three groups was statistically significant(χ^(2)=54.00,58.00,42.00,46.87,32.00;all P<0.05).FeNO values were positively correlated with total IgE(r=0.5275,P<0.05).The ROC curves suggested that the value of the combined diagnosis of AS+AR by FeNO,EOS,total IgE and pulmonary function tests was greater than that of single-indicator tests,and the optimal threshold for FeNO to diagnose AS+AR was 38.34 ppb.Conclusions FeNO,peripheral blood EOS,and serum IgE were elevated in children with asthma combined w

关 键 词：呼出气一氧化氮 外周血嗜酸性粒细胞 过敏原 儿童哮喘 过敏性鼻炎 

分 类 号：R562.25[医药卫生—呼吸系统]