无创性临床指标在慢性鼻窦炎伴鼻息肉合并哮喘诊断中的应用价值

The value of noninvasive clinical parameters in the diagnosis of chronic rhinosinusitis with nasal polyps and asthma

目的 比较无创性临床指标在预测慢性鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyps,CRSwNP)合并哮喘诊断中的价值。方法 纳入30例CRSwNP不合并哮喘和40例CRSwNP合并哮喘患者。用Logistic回归分析CRSwNP伴哮喘的因素。用受试者工作特征(receiver operating characteristic,ROC)曲线评价各指标在CRSwNP合并哮喘诊断中的预测效能。结果 Logistic回归分析显示,年龄、第1秒用力呼气容积(forced expiratory volume in one second,FEV1)/用力肺活量(forced vital capacity,FVC)和呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)与CRSwNP合并哮喘相关(P均<0.05)。ROC曲线显示FEV1/FVC和FeNO对CRSwNP合并哮喘有中等程度的准确性(AUC分别为0.816和0.768),年龄有较低的准确性(AUC=0.658),而联合模型可进一步提高诊断准确性(AUC=0.921)。结论 无创性临床指标FEV1/FVC、FeNO和年龄联合模型对于CRSwNP合并哮喘具有更高的诊断价值。

OBJECTIVE To compare the value of noninvasive clinical parameters in diagnosis of chronic rhinosinusitis with nasal polyps(CRSwNP) and asthma.METHODS Thirty CRSwNP without asthma patients and 40 CRSwNP with asthma patients were included for this study.Logistic regression analysis was used to evaluate the related factors of CRSwNP with asthma.Receiver operating characteristic(ROC) curve was used to assess the predictive potential predictors for CRSwNP with asthma.RESULTS Logistic regression analysis showed that age,forced expiratory volume in one second(FEV1)/forced vital capacity(FVC),and fractional exhaled nitric oxide(FeNO) are risk factors of CRSwNP with asthma.ROC indicated FEV1/FVC and FeNO to have moderate predictive accuracy,and age to have low predictive accuracy for CRSwNP with asthma,with ROC area under curve(AUC) value of 0.816,0.768 and 0.658,respectively,which was further improved by combination of these indicators(AUC=0.921).CONCLUSION The combined model on FEV1/FVC,FeNO,and age provide the predictive value for CRSwNP with comorbid asthma.