呼出气一氧化氮检测对支气管哮喘的诊断价值研究

Study on the diagnostic value of functional inhaled nitric oxide in bronchial asthma

目的评估呼出气一氧化氮(FENO)检测在支气管哮喘诊断中的价值。方法对以慢性咳嗽或反复发作性喘息等哮喘疑似症状为主要表现的患者305例纳入研究,同时进行支气管激发、舒张试验和FENO检测,以支气管激发结果结合临床作为诊断哮喘标准,以此作为参照评价FENO检测对诊断支气管哮喘的价值。结果哮喘组PC20-FEV1.0值低于非哮喘组(7.68±5.22与12.50±0.00,P<0.05),FENO值高于非哮喘组(59.00±50.37与14.44±6.62,P<0.05);FENO法诊断支气管哮喘的敏感度是70.30%,特异度84.62%,阳性预测值92.12%,阴性预测值67.65%,与传统支气管激发舒张法比较差异无统计学意义(P>0.05)。结论 FENO对于支气管哮喘诊断价值与传统肺功能法相似,FENO和支气管激发、舒张法联合应用,诊断敏感度与特异度均进一步提高,FENO检测对支气管哮喘诊断具有一定临床应用价值。

Objective To assess the diagnostic value of functional inhaled nitric oxide （FENO） measurement in the diagnosis of bronchial asthma. Methods 305 subjects were collected in the study who suffered chronic cough or recurrent wheezing in the General Hospital of Ningxia Medical University between Oct. 2011 and May 2012. All patients underwent bronchial provocation/dilation test and FENO test, and then the patients＇ bronchial provocation/dilation test was positive as case group. The diagnostic value of functional in- haled nitric oxide （FENO） measurement was assessed in asthma cases. Results The level PC20FEV1 was lower in asthma group （7.68 ＋ 5.22） than that in control group （ 12.50 -＋ 0.00） （ P 〈 0.05 ）. FENO was higher in asthma group （59.00 ＋ 50.37） than that in control group （ 14.44 ＋ 6.62） （ P 〈 0.05 ）. The sensitivity of FENO test was 70.30% and the specificity was 84.62%. The positive predictive value was 92.12% and the negative predictive value was 67.65%. There was no significantly difference in diagnosis of asthma between traditional method and FENO test （P 〉 0.05）. Conclusion FENO test resembles traditional bronchial stimulate/diastolic test in the diagnosis of asthma. It can improve the diagnostic sensitivity and specificity when combined FENO test with bronchial stimulate/ diastolic test. The FENO test has some clinical value for the diagnosis of bronchial asthma.