咳嗽变异性哮喘患者血清25(OH)VD3、IL-4联合呼出气一氧化氮的表达及临床意义

Expression of Serum 25(OH) VD3 and IL-4 Combined with Exhaled Nitric Oxide in Patients with Cough Variant Asthma and Its Clinical Significance

目的:探讨血清25(OH)VD3,IL-4,FENO的检测在咳嗽变异性哮喘中的诊断价值。方法:收集从2018年12月至2019年11月来自佳木斯大学附属第一医院呼吸内科门诊就诊并确诊的咳嗽变异性哮喘患者60例;对照组选取同一时间段健康体检者40例。分别测定血清25(OH)VD3,IL-4,FENO水平以及分别计算三者对CVA的诊断价值。结果:两组血清25(OH)VD3,IL-4,FENO水平有显著性差异(P<0.05);血清25(OH)VD3诊断CVA的ROC曲线下面积为0.965(P<0.001),截断值为22.665ng/ml时,25(OH)VD3诊断CVA的灵敏度和特异度为87.5%和93.3%;FENO诊断CVA的ROC曲线下面积为0.980(P<0.001),截断值为35.5ppb时,FENO诊断CVA的灵敏度和特异度95.0%和97.5%;IL-4诊断CVA的曲线下面积为0.776(P<0.001),截断值为435.80 ng/L,敏感度和特异性分别为90.0%和55.00%;结论:咳嗽变异性哮喘患者血清25(OH)VD3降低,IL-4,FENO水平增高,联合检测上述指标可有效提高CVA诊断。

Objective:To investigate the diagnostic value of serum 25(OH)VD3,IL-4 and FENO in cough variant asthma.Methods:Sixty patients with CVA were selected as the observation group,and 40 healthy patients as the control group.The serum levels of 25(OH)VD3,IL-4 and FENO were measured respectively.Results:There were significant differences in serum 25(OH)VD3,IL-4,FENO levels between the two groups(P<0.05);the area under the ROC curve of serum 25(OH)VD3 diagnosis of CVA was 0.965(P<0.05),truncated When the value is 22.665 ng/mL,the sensitivity and specificity of 25(OH)VD3 diagnosis of CVA is 87.5%and 93.3%;the area under the ROC curve of CVA diagnosed by FENO is 0.980(P<0.05),and the cutoff value is 35.5 ppb.The sensitivity and specificity of CVA 95.0%and 97.5%;the area under the curve of IL-4 diagnosis of CVA is 0.776(P<0.05),the cut-off value is 435.80 ng/l,and the sensitivity and specificity are 90.0%and 55.00%,respectively;Conclusion:The serum 25(OH)VD3 in patients with cough variant asthma is decreased,and the levels of IL-4 and FENO are increased.The combined detection of the above indicators can effectively improve the sensitivity of CVA diagnosis.