中国全科医学Issue(29)：3430-3434,5.DOI:10.3969/j.issn.1007-9572.2014.29.007
呼出气一氧化氮监测对支气管哮喘的诊断及治疗评估价值研究
Value of Fractional Exhaled Nitric Oxide in Asthma Diagnosis and Treatment
摘要
Abstract
Objective To evaluate the value of fractional exhaled nitric oxide( FeNO)in diagnosis of asthma and its therapeutic reactions. Methods From July 2013 to February 2014,in Respiratory Medicine of the First Affiliated Hospital of Sun Yet-sen University,266 suspected bronchial asthma( BA)patients underwent examinations with FeNO analyzer. Taking traditional pulmonary function testing as diagnostic gold standard,we drew ROC curve of FeNO diagnosing BA and determined its cut-off point. The correlation between PC20 stimulated by FEV1 decreasing by 20% and FeNO was analyzed. The diagnosed patients were given budesonide inhalation therapy,200 μg/time,twice/d,12 wk. The changes of FeNO and lung function be-fore and after treatment were detected and the role of FeNO in BA treatment evaluated. Results In 266 suspected BA patients, 127 were diagnosed at last,35 took medicine normatively. FeNO level was higher in BA group than in non-BA group〔(65. 66 ± 33. 68)μg/L vs. (29. 49 ± 20. 56)μg/L,t=7. 89,P<0. 05〕. FeNO was negatively correlated with PC20 in patients with positive provocative test(r= -0. 599,P<0. 05). The area under ROC curve of FeNO diagnosing BA was 0. 861,the best cut-off point was 46. 5 μg/L. The sensitivity of FeNO=46. 5 μg/L diagnosing BA was 70. 1%,specificity 93. 9%,posi-tive predictive value 93. 2%,negative predictive value 72. 7%. FeNO and FEV1% were better after treatment〔(46. 36 ± 23. 18)μg/L vs. (85. 12 ± 38. 19)μg/L,t=9. 45,P<0. 05;(84. 89 ± 12. 68)vs. (75. 46 ± 13. 75),t=4. 79,P<0. 05〕. Conclusion In BA screening and diagnosis,FeNO is of high sensitivity and specificity. Continuous FeNO monitoring contributes to BA's evaluation of treatment and management.关键词
一氧化氮/支气管哮喘/诊断/ROC曲线Key words
Nitric oxide/Bronchial asthma/Diagnosis/ROC curve分类
医药卫生引用本文复制引用
陈凤佳,严英硕,周燕斌..呼出气一氧化氮监测对支气管哮喘的诊断及治疗评估价值研究[J].中国全科医学,2014,(29):3430-3434,5.基金项目
2012年广东省自然科学基金资助项目 （）
