血清总IgE、EOS、LDH和呼出气一氧化氮对过敏性鼻炎合并支气管哮喘的预测价值  

Predictive value of serum total IgE,eosinophils,diamine oxidase and fractional exhaled nitric oxide in allergic rhinitis combined with bronchial asthma

作　　者：朱永红 巴军凤 ZHU Yonghong;BA Junfeng(Pediatric Internal Medicine Department,Huaibei Maternal and Child Health Hospital,Huaibei 235000,China)

机构地区：[1]安徽省淮北市妇幼保健院儿一科,235000

出　　处：《天津医药》2025年第4期360-364,共5页Tianjin Medical Journal

基　　金：安徽省卫生健康委科研项目(AHWJ2021b104)。

摘　　要：目的探讨血清总IgE、嗜酸性粒细胞(EOS)、乳酸脱氢酶(LDH)联合呼出气一氧化氮(FeNO)水平对过敏性鼻炎(AR)合并支气管哮喘(BA)的预测价值。方法127例AR患儿根据是否合并BA分为AR组(84例)和AR+BA组(43例),另选取55例健康体检儿童作为对照组。比较3组的一般资料和总IgE、EOS比例、LDH水平、FeNO水平,分析各指标与疾病症状持续时间和鼻部症状评分的相关性,并进行受试者工作特征(ROC)曲线分析,评估各指标对AR及AR+BA的预测价值。结果AR组和AR+BA组的总IgE、EOS比例、LDH、FeNO水平均高于对照组(P<0.05),AR+BA组的总IgE、EOS比例、FeNO水平均高于AR组(P<0.05)。相关性分析显示,AR组和AR+BA组总IgE、EOS比例、FeNO水平与患者疾病症状持续时间和症状评分呈正相关(P<0.05)。AR组患儿LDH水平与疾病症状持续时间和鼻部症状评分呈正相关(P<0.05),但在AR+BA组中与症状持续时间和BA症状评分无线性相关性(P>0.05)。ROC曲线分析结果显示,总IgE、FeNO、EOS比例和LDH对AR及AR+BA均有一定的预测价值,总IgE对AR和AR+BA预测价值均较高[曲线下面积(AUC)分别为0.971和0.800]。联合检测总IgE、EOS比例、LDH、FeNO对AR+BA的预测价值最好(AUC=0.904)。结论血清总IgE、LDH、EOS比例、FeNO水平均可作为预测AR合并BA的有效指标,联合检测可提高预测的准确性,为临床早期识别和干预AR+BA提供参考依据。Objective To investigate the predictive value of serum total IgE,eosinophil(EOS)ratio,lactate dehydrogenase(LDH)and exhaled nitric oxide(FeNO)levels in allergic rhinitis(AR)complicated with bronchial asthma(BA).Methods A total of 127 children with AR were divided into the AR group(84 cases)and the AR+BA group(43 cases)based on the presence of BA.Another 55 healthy children were selected as the control group.General data,total IgE,EOS ratio,LDH and FeNO levels were compared between the three groups.The correlation between these indicators and duration of disease symptoms,nasal symptom scores were analyzed.Receiver operating characteristics(ROC)curve analysis was performed to evaluate the predictive value of these indicators for AR and AR+BA.Results Total IgE,EOS ratio,LDH and FeNO levels were significantly higher in the AR group and the AR+BA group than those in the control group(P<0.05).The total IgE,EOS ratio and FeNO levels were higher in the AR+BA group than those in the AR group(P<0.05).Correlation analysis showed that total IgE,EOS ratio and FeNO levels were positively correlated with the duration of disease symptoms and symptom scores in the AR group and the AR+BA group(P<0.05).In the AR group,LDH levels were positively correlated with the duration of disease symptoms and symptom scores(P<0.05),but in the AR+BA group,there was no significant correlation between the duration of BA symptoms and symptom scores(P>0.05).ROC curve analysis indicated that total IgE,FeNO,EOS ratio and LDH all had predictive values for both AR and AR+BA.The predictive value of total IgE for AR and AR+BA was higher(AUC=0.971 and 0.800).Combined detection of total IgE,EOS ratio,LDH and FeNO had the best predictive value for AR+BA(AUC=0.904).Conclusion Serum levels of total IgE,LDH,EOS ratio and FeNO can be served as effective indicators for predicting AR complicated with BA.Combined detection can improve the accuracy of prediction and provide a reference for early clinical identification and intervention in AR+BA.

关 键 词：鼻炎 过敏性 哮喘 总IGE 中性粒细胞 乳酸脱氢酶 呼出气一氧化氮 

分 类 号：R725.62[医药卫生—儿科] R765.21[医药卫生—临床医学]