呼出气一氧化氮水平与诱导痰嗜酸性粒细胞联合检测对哮喘-慢性阻塞性肺疾病重叠综合征、哮喘、慢性阻塞性肺疾病患者的诊断价值

Diagnostic value of combined detection with fractional exhaled nitric oxide level and induced sputum eosinophils in patients with asthma-chronic obstructive pulmonary disease overlap syndrome,asthma,chronic obstructive pulmonary disease

目的探讨呼出气一氧化氮(FeNO)水平与诱导痰嗜酸性粒细胞(EOS)联合检测对哮喘-慢性阻塞性肺疾病重叠综合征(ACOS)、哮喘、慢性阻塞性肺疾病(COPD)患者的诊断价值。方法选取2017年1月~2019年1月我院呼吸内科诊治的120例患者作为研究对象,根据疾病类型将其分为ACOS组、哮喘组、COPD组,每组各40例,再选择同期、同性别、同年龄健康体检人群40例作为对照组。观察受试人群FeNO与诱导痰EOS变化情况,比较FeNO、诱导痰EOS与两者联合检测ACOS、哮喘、COPD的受试者工作特征(ROC)曲线及诊断效能。结果ACOS组、哮喘组、COPD组的FeNO水平、诱导痰EOS均高于对照组,且三组间两两比较,差异有统计学意义(P<0.05)。ROC曲线分析显示,FeNO水平联合诱导痰EOS检测ACOS、哮喘、COPD的准确性、特异性均高于FeNO水平、EOS检测,差异有统计学意义(P<0.05)。结论FeNO与诱导痰EOS联合检测可提升对ACOS、哮喘、COPD的诊断价值。

Objective To explore the diagnostic value of combined detection with fractional exhaled nitric oxide(FeNO)level and induced sputum eosinophils(EOS)in patients with asthma-chronic obstructive pulmonary disease overlap syndrome(ACOS),asthma,chronic obstructive pulmonary disease(COPD).Methods A total of 120 patients who were diagnosed and treated in respiratory medicine department of our hospital from January 2017 to January 2019 were enrolled as study objects.According to disease types,they were divided into ACOS group,asthma group and COPD group,40 cases in each group.Another 40 healthy people with the same gender and age who underwent physical examination at the same period were enrolled as control group.The changes in FeNO and induced sputum EOS were observed.Receiver operating characteristic(ROC)curve and diagnostic efficiency of FeNO,induced sputum EOS and their combination for detecting ACOS,asthma and COPD were compared.Results The level of FeNO and induced sputum EOS in ACOS group,asthma group and COPD group were higher than those in control group,and there were statistically significant differences between any two of the three groups(P<0.05).ROC curve analysis showed that accuracy and specificity of FeNO combined with induced sputum EOS for detecting ACOS,asthma,and COPD were higher than those of their single detection,with statistically significant differences(P<0.05).Conclusion The combined detection of FeNO and induced sputum EOS can increase diagnostic value in ACOS,asthma and COPD.