呼出气一氧化氮检测在幼儿支气管哮喘中的应用分析

Utility of fractional exhaled nitric oxide in children with asthma

摘要:

目的 分析各期支气管哮喘(AS)幼儿的呼出气一氧化氮(FeNO)浓度变化,探讨FeNO浓度与AS分期的相关性.方法 选取2014年4~6月初次诊断为AS且处于急性发作期的1~3岁患儿58例为研究对象,依据治疗后病情转归情况分为慢性持续期(n=34)及临床缓解期(n=24),以同龄健康儿童30例为对照,对所有儿童行FeNO浓度、肺功能等检测.分析FeNO浓度与AS分期的相关性.利用受试者工作特征(ROC)曲线分析FeNO诊断AS的最佳诊断截点.结果 各期AS患儿FeNO浓度均高于对照组儿童(P<0.05).急性发作期患儿FeNO浓度高于慢性持续期和临床缓解期,且慢性持续期患儿FeNO浓度高于临床缓解期(均P<0.05).AS患儿FeNO浓度水平与AS分期相关(r=-0.382,P<0.05).ROC曲线分析显示FeNO诊断AS的最佳诊断截点为22.75 ppb,敏感度达0.933,但特异度仅为0.388.结论 AS幼儿FeNO浓度水平与AS分期相关;FeNO浓度>22.75 ppb可作诊断幼儿AS的界值.

Abstract:

Objective To study the utility of fractional exhaled nitric oxide (FeNO) in young children at different stages of asthma. Methods Fifty-eight children with newly diagnosed asthma (aged 1-3 years) at the acute exacerbation stage between April and June, 2014 were recruited. After 3 months' treatment, the children switched into the chronic persistent stage (n=34) or remission stage (n=24). Thirty aged-matched healthy children served as controls. FeNO levels and lung function were measured for all subjects. The best cut-off value of FeNO for the diagnosis of asthma was evaluated by receiver operating characteristic (ROC) curve. Results The FeNO levels in children with asthma at various stages were higher than controls (P<0.05). The FeNO levels in the acute exacerbation stage were highest, followed by the chronic persistent stage (P<0.05). FeNO level was correlated to the stages of asthma (r=-0.382, P<0.001). The cut-off value of FeNO for the diagnosis of asthma was 22.75 ppb by ROC curve, with the sensitivity of 0.933 and the specificity of 0.388. Conclusions The children with asthma at different stages have different FeNO levels. Measurement of FeNO is useful in the diagnosis of asthma in young children.