FeNO联合肺功能检测在慢性咳嗽病人小气道病变及病因诊断中的价值

Value of FeNO combined with lung function test in the diagnosis of small airway lesions and etiology in patients with chronic cough

目的:探讨呼出气一氧化氮(FeNO)联合肺功能检测在慢性咳嗽病人小气道病变及病因诊断中的应用价值。方法:选择慢性咳嗽病人166例,根据肺功能检测结果分为有小气道病变和无小气道病变2组,分析小气道功能异常组FeNO与小气道功能指标、痰诱导嗜酸性粒细胞(EOS)、IgE等水平的相关性;利用ROC曲线分析FeNO水平对慢性咳嗽病人小气道功能异常的预测价值。并分析FeNO在慢性咳嗽病因诊断中的价值。结果:用FeNO对小气道疾病进行ROC曲线分析,结果显示,曲线下面积为0.776,95%CI为0.720~0.832;FeNO预测小气道病变的最佳阈值为29.0 ppb,相对应的敏感度为60.7%,特异度为82.5%;用FeNO对慢性咳嗽中诊断CVA的价值进行ROC曲线分析,结果显示,曲线下面积为0.902,95%CI为0.864~0.935;FeNO预测CVA最佳阈值为40.1 ppb,相对应的敏感度为83.3%,特异度为86.7%。结论:FeNO联合肺功能检测在慢性咳嗽小气道病变诊断中具有重要价值。

Objective:To investigate the value of fractional exhaled nitric oxide(FeNO)combined with pulmonary function test in the diagnosis of small airway lesions and etiology in patients with chronic cough.Methods:One hundred and sixty-six patients with chronic cough were divided into the small airway lesion group and no small airway lesion group according to the results of pulmonary function test.The correlation between FeNO and small airway function indexes,sputum-induced EOS and IgE level in small airway lesion group were analyzed.The ROC curve was used to analyze the predictive value of FeNO level in small airway lesion patients with chronic cough.The value of FeNO in the diagnosis of chronic cough was analyzed.Results:The ROC curve was used to analyze small airway lesion by FeNO,the results showed that the area under the curve was 0.776,and the 95%CI was 0.720-0.832.The optimal threshold of FeNO in predicting small airway lesion was 29.0 ppb,and the corresponding sensitivity and specificity were 60.7%and 82.5%,respectively.The ROC curve of FeNO in diagnosing the CVA during chronic cough was analyzed,the results showed that the area under the curve was 0.902,and the 95%CI was 0.864-0.935.The optimal threshold of FeNO in predicting CVA was 40.1 ppb,the corresponding sensitivity and specificity were 83.3%and 86.7%,respectively.Conclusions:FeNO combined with pulmonary function test is of great value in the diagnosis of chronic cough small airway lesion.