FeNO联合血清SDF-1水平对支气管哮喘患者气道高反应的预测价值

Predictive value of FeNO combined with serum SDF-1 level on airway hyperresponsiveness in patients with bronchial asthma

目的探讨呼出气一氧化氮(FeNO)联合血清基质细胞衍生因子-1(SDF-1)水平对支气管哮喘患者气道高反应的预测价值。方法选取2017年6月-2020年6月于本院就诊的支气管哮喘患者103例为观察组,同期选取健康人群103例为对照组。采用纳库仑呼气分析仪测定FeNO水平;采用酶联免疫吸附(ELISA)法检测所有研究对象SDF-1水平,并以支气管激发试验检测气道高反应性[以比气道传导率下降35%的乙酰甲胆碱浓度(PC35sGaW)表示];采用Pearson分析支气管哮喘患者FeNO、血清SDF-1水平与PC35sGaW的相关性;采用Logistic回归分析影响支气管哮喘患者气道高反应发生的相关因素;采用ROC曲线分析FeNO、SDF-1对支气管哮喘患者气道高反应的预测价值。结果观察组FeNO、血清SDF-1水平均显著高于对照组(P<0.05),PC35sGaW显著低于对照组(P<0.05);Pearson相关性分析结果显示,支气管哮喘患者FeNO、血清SDF-1水平均与PC35sGaW呈负相关(P<0.05);Logistic回归分析结果显示,FeNO、SDF-1升高均为影响支气管哮喘患者发生气道高反应的独立危险因素(P<0.05);ROC曲线分析结果显示,FeNO、血清SDF-1预测支气管哮喘患者气道高反应的曲线下面积分别为0.660、0.785(P<0.001),截断值分别为29.203 ppb、403.574 ng/L,敏感度分别为70.9%、55.3%,特异度分别为55.3%、89.3%;FeNO联合血清SDF-1预测支气管哮喘患者气道高反应的曲线下面积分别为0.813(P<0.001),敏感度为61.2%,特异度为89.3%。结论支气管哮喘患者FeNO、血清SDF-1水平显著升高,均与患者气道高反应性密切相关,对支气管哮喘患者气道高反应具有一定的预测价值,且二者联合价值更高。

Objective To investigate the predictive value of fractional exhaled nitric oxide(FeNO)combined with serum stromal cell-derived factor-1(SDF-1)level for airway hyperresponsiveness in patients with bronchial asthma.Methods A total of 103 patients with bronchial asthma in our hospital from June 2017 to June 2020 were selected as the observation group,and 103 healthy people were selected as the control group.The level of FeNO was measured by naculomb breath analyzer,the level of SDF-1 was detected by enzyme-linked immunosorbent assay(ELISA),and airway hyperresponsiveness[expressed as concentration of methacholine which was 35%lower than the airway conductivity(PC35sGaW)]was measured by bronchial provocation test.Pearson analysis was used to analyze the correlation between FeNO,serum SDF-1 level and PC35sGaW.Logistic regression analysis was used to analyze the related factors of airway hyperresponsiveness in patients with bronchial asthma.ROC curve was used to analyze the predictive value of FeNO and SDF-1 in patients with bronchial asthma.Results FeNO and serum SDF-1 level in the observation group were significantly higher than those in the control group(P<0.05),and PC35sGaW was significantly lower than that in the control group(P<0.05).Pearson correlation analysis showed that FeNO and serum SDF-1 level were negatively correlated with PC35sGaW(P<0.05).Logistic regression analysis showed thatthe increases of FeNO and SDF-1 were independent risk factors of airway hyperresponsiveness in patients with bronchial asthma(P<0.05).ROC curve analysis showed that the area under the curve of FeNO and serum SDF-1 in predicting airway hyperresponsiveness in patients with bronchial asthma was 0.660 and 0.785 respectively(P<0.001),the cut-off value was 29.203 ppb and 403.574 ng/L,respectively,with sensitivity of 70.9%,55.3%and specificity of 55.3%and 89.3%,respectively.The area under the curve of FeNO combined with serum SDF-1 was 0.813(P<0.001),the sensitivity was 61.2%,and the specificity was 89.3%.Conclusion The levels of FeNO and serum SDF-1 in patients with bronchial asthma are significantly increased,they are closely related to airway hyperresponsiveness,and have certain predictive value on airway hyperresponsiveness in patients with bronchial asthma.The combined value of the two is higher.