呼出气一氧化氮检测对职业性哮喘的诊断价值及其与肺功能的相关性分析

The diagnostic value of fractional exhaled nitric oxide in occupational asthma and its correlation with pulmonary function

目的评估呼出气一氧化氮(FeNO)检测在职业性哮喘(OA)中的诊断价值,并分析其与OA患者肺功能的相关性。方法于2019年10月,收集2012年1月至2018年12月来我院申请OA诊断的64例劳动者的临床资料,回顾性分析其肺功能、FeNO及血常规结果,评价FeNO检测对OA的诊断价值,比较不同程度OA患者FeNO及肺功能指标情况,并进行相关性分析。结果OA组患者FeNO值[(58.4±13.1)ppb]高于非OA组患者[(30.1±13.7)ppb](P<0.05);中度OA患者FeNO值[(68.9±13.8)ppb]高于轻度OA患者[(54.2±10.3)ppb](P<0.05)。FeNO诊断OA的受试者工作特征(ROC)曲线下面积为0.9453(95%CI:0.8928~0.9978,P<0.05),最佳截点是47.5 ppb,敏感度为88.6%,特异度为89.7%。OA患者FeNO值与第1秒用力呼气容积占预计值百分比(FEV1%pred)呈负相关(r=-0.454,P<0.01)。结论FeNO检测对OA诊断具有一定临床应用价值,在实际工作中应结合FeNO和肺功能指标进行判断。

Objective To investigate the value of fractional exhaled nitric oxide(FeNO)in the diagnosis of occupational asthma(OA),and analyze the correlation between FeNO and pulmonary function in patients with OA.Methods In October 2019,clinical datas,including pulmonary function,FeNO and blood routine test of 64 workers who applied for the diagnosis of OA in January 2012 to October 2018 in our hospital were collected.The diagnostic value of FeNO in OA was evaluated,FeNO and pulmonary function in different degrees of OA were compared,and the correlations were analyzed.Results The FeNO value of OA patients[(58.4±13.1)ppb]was higher than non-OA patients[(30.1±13.7)ppb](P<0.05).The FeNO value of patients with moderate OA[(68.9±13.8)ppb]was higher than that of patients with mild OA[(54.2±10.3)ppb](P<0.05).The area under the receiver operating characteristic(ROC)curve of FeNO in the diagnosis of OA was 0.9453(95%CI:0.8928-0.9978,P<0.05),the optimal cut-off point is 47.5 ppb,and the sensitivity and specificity are 88.6%and 89.7%respectively.There was negative correlation between FeNO and FEV1%pred(r=-0.454,P<0.01).Conclusion FeNO has a clinical application value in the diagnosis of OA.It should be combined with pulmonary function index in practical work.