呼出气一氧化氮检测在哮喘诊断中的价值研究

Study on the value of nitric oxide in the diagnosis of asthma

目的:探讨哮喘诊断中应用呼出气一氧化氮检测的价值。方法:选择我院门诊就诊的120例疑似哮喘患者(2016-01～2018-08),对其呼出气一氧化氮水平、FEV1/FVC进行测定,以支气管激发试验为金标准,比较呼出气一氧化氮、FEV1/FVC对哮喘的诊断结果,分析其诊断结果与支气管激发试验诊断结果之间的一致性。根据哮喘患者病情严重程度分为轻中度哮喘组与重度哮喘组,比较组间呼出气一氧化氮水平、FEV1/FVC,分析呼出气一氧化氮与哮喘发生、FEV1/FVC的相关性,并给予其雾化吸入治疗,比较治疗前后的呼出气一氧化氮水平、FEV1/FVC。结果:以支气管激发试验为金标准,呼出气一氧化氮对哮喘的诊断灵敏度、特异度、准确率均高于FEV1/FVC(P<0.05),而呼出气一氧化氮与支气管激发试验诊断结果间的一致性优于FEV1/FVC。重度哮喘组的呼出气一氧化氮水平高于轻中度哮喘组(P<0.05),其FEV1/FVC低于轻中度哮喘组(P<0.05),而相关性分析发现,呼出气一氧化氮水平与哮喘发生呈正相关,其与FEV1/FVC之间无线性相关。治疗后哮喘患者的呼出气一氧化氮水平较治疗前降低(P<0.05),其FEV1/FVC较治疗前增高(P<0.05)。结论:呼出气一氧化氮不仅对哮喘具有较高的诊断价值,还可用于评估哮喘患者病情严重程度及临床疗效。

Objective: To explore the value of the detection of exhaled nitric oxide in the diagnosis of asthma. Methods: 120 Patients with suspected asthma (from January 2016 to August 2018) were selected from our outpatient clinic. The level of nitric oxide and FEV 1 / FVC were measured, and the bronchial provocation test was used as the gold standard. The diagnostic results of asthma by FEV1 / FVC were compared, and the consistency between the diagnostic results of FEV1 / FVC and bronchial provocation test was analyzed. According to the severity of asthma patients, they were divided into mild and moderate asthma group and severe asthma group. The level of exhaled nitric oxide and FEV1 / FVC were compared between the two groups, and the correlation between exhaled nitric oxide and the occurrence of FEV1 / FVC in asthma were analyzed, and the aerosol inhalation therapy was given. The level of exhaled nitric oxide and FEV 1 / FVC were compared before and after treatment. Results: The diagnostic sensitivity, specificity and accuracy of exhaled nitric oxide for asthma were higher than those of FEV1/FVC (P<0.05), and the consistency between exhaled nitric oxide and bronchial provocation test was better than that of FEV1/FVC. The level of exhaled nitric oxide in severe asthma group was higher than that in mild to moderate asthma group (P<0.05), and its FEV1/FVC was lower than that in mild to moderate asthma group (P<0.05). After treatment, the level of exhalation nitric oxide in asthma patients was lower than that before treatment (P<0. 05), and its FEV1/FVC was higher than that before treatment (P<0.05). Conclusion: Exhaled nitric oxide not only has high diagnostic value for asthma, but also can be used to evaluate the severity and clinical efficacy of asthma.