肺泡一氧化氮测定在老年哮喘患者中的临床价值

Clinical values of CaNO in elderly asthmatic patients

目的通过对老年哮喘患者肺泡一氧化氮测定(CaNO)与肺功能的关系的研究,探讨CaNO在老年哮喘患者中的临床意义。方法2020年1月至2020年9月年龄大于60岁,首次因咳嗽或呼吸困难症状超过3周于我院就诊的患者,行口呼气一氧化氮(FeNO)和CaNO测定及肺功能检查,分为哮喘组和非哮喘组,比较两组CaNO、FeNO与肺功能指标的关系。结果共纳入研究对象160名,其中男性62名(38.75%),女性98名(61.25%);哮喘组80人,非哮喘组80人,两组间一般情况比较无统计学差异。哮喘组FeNO均值(44.575±30.018)ppb,高于非哮喘组的(21.300±7.876)ppb,组间差异有显著统计学意义。哮喘组CaNO均值为(13.670±8.324)ppb,高于非哮喘组的(9.013±4.971)ppb,组间差异有显著统计学意义。CaNO与FeNO呈正相关(r=0.254,P值=0.001),CaNO和FeNO与FEV_(1)/FVC、MEF75%pred、MEF50%pred、MEF25%pred、MMEF%pred、FEV_(1)%pred呈负相关。老年哮喘患者中,ROC曲线下FeNO的截断值为31.5ppb,ROC曲线下面积为0.772(95%CI 0.698~0.847)。CaNO的ROC曲线下截断值为14.3ppb,曲线下面积为0.666(95%CI 0.582~0.750),二者联合检测的曲线下面积为0.831(95%CI 0.768~0.894)。结论对于老年哮喘患者FeNO和CaNO有辅助诊断价值,,二者联合检测诊断价值最高。FeNO和CaNO越高,提示小气道功能越差,CaNO比FeNO更敏感地反映气道炎症情况。

Objective To explore the clinical value of CaNO in elderly asthmatic patients through the study of the relationship between CaNO and pulmonary function in elderly asthmatic patients.Methods In this study,the patients older than 60 with cough or dyspnea symptoms for more than 3 weeks were selected from January 2020 to September 2020,and they were given FeNO and CaNO determination and pulmonary function test.They were divided into the asthma group and the control group based on their condition,then the relationship of CaNO and FeNO with lung function were compared between the two groups.Results 160 cases were included,including 62 males(38.75%)and 98 females(61.25%),and 80 asthmatic cases and 80 non asthmatic cases.There was no significant difference in general data between the two groups.The mean FeNO level in the asthma group was(44.575±30.018)ppb,which was significantly higher than that in the control group(21.30±7.876)ppb.The mean value of CaNO in the asthma group was(13.670±8.324)ppb,which was significantly higher than that in the control group(9.013±4.971)ppb.There was a positive correlation between CaNO and FeNO(r=0.254,P=0.001).CaNO and FeNO were negatively correlated with FEV_(1)/FVC,MEF75%pred,MEF50%pred,and MEF25%pred,MMEF%pred,FEV_(1)%pred.The area under ROC curve of FeNO diagnosing asthma was 0.772(95%CI 0.698-0.847),and the best cut-off point was 31.5ppb.The area under ROC curve of CaNO diagnosing asthma was 0.666(95%CI 0.582-0.750),and the best cut-off point was 14.3ppb.The area under ROC curve of combined detection of FeNO and CaNO was 0.831(95%CI 0.768-0.894).Conclusion For elderly asthmatic patients,FeNO and CaNO have certain diagnostic value.The combined detection of FeNO and CaNO is the most valuable in the diagnosis of asthma.The higher the level of FeNO and CaN o in asthmatic patients,the worse the function of small airway is.CaNO is more sensitively than FeNO to reflecting airway inflammation.