血清IL-17A联合FeNO在慢性咳嗽患者使用布地奈德福莫特罗吸入剂疗效的预测价值

The predictive value of serum IL-17A and FeNO on the efficacy of budesonide and formoterol inhalants in patients with chronic cough

目的探讨血清IL-17A联合呼出气一氧化氮(FeNO)在慢性咳嗽患者中使用布地奈德福莫特罗吸入剂疗效的预测价值。方法选取2020年5月~2022年3月我院呼吸内科门诊就诊的81例慢性咳嗽患者作为观察组,将布地奈德福莫特罗吸入剂(ICS+LABA)治疗4周后治疗有效的患者列为A组(52例)、治疗无效的患者列为B组(29例),另选取25例健康志愿者为对照组,比较各组基线FeNO及血清中IL-17A,采用ROC曲线评价FeNO和血清IL-17A联合检测对慢性咳嗽患者使用布地奈德福莫特罗吸入剂治疗效果的预测价值。结果治疗前,A组、B组、对照组间FeNO和血清IL-17A的差异均有统计学意义(P<0.05);ROC曲线显示,FeNO预测应用布地奈德福莫特罗吸入剂治疗效果的AUC为0.749[95%CI(0.640~0.839)],最佳截断值为29ppb,此时敏感度、特异度分别为51.92%、93.10%;IL-17A的AUC为0.654[95%CI(0.540~0.756)],最佳截断值为4.38 pg/mL,此时敏感度、特异度分别为61.54%、68.97%;两者联合后的AUC为0.834[95%CI(0.735~0.908)],与单独检测相比差异有统计学意义(P<0.05)。结论血清IL-17A联合FeNO检测对于慢性咳嗽的评估及指导治疗有一定的临床意义。

Objective To investigate the predictive value of serum IL-17A and Fractional exhaled nitric oxide(FeNO)on the efficacy of budesonide and formoterol inhalation in patients with chronic cough.Methods A total of 81 patients with chronic cough who received treatment in the respiratory department outpatient Department of our hospital from May 2020 to March 2022 were selected as the observation group.Patients who were effective after 4 weeks of treatment with budesonide and formoterol inhalant(ICS+LABA)were classified as Group A(52 cases)and those who were ineffective were classified as Group B(29 cases).Another 25 healthy volunteers were selected as the control group.The baseline of FeNO and serum IL-17A in each group were compared.ROC curve was used to evaluate the predictive value of FeNO and serum IL-17A for the efficacy of budesonide and formoterol inhalants in patients with chronic cough.Results Before treatment,FeNO,and serum IL-17A were significantly different among Group A,Group B and control group(P<0.05).ROC curve showed that the AUC of FeNO was 0.749[95%CI(0.640~0.839)]in the prediction of the efficacy,the optimal cut-off value was 29ppb,and the sensitivity and specificity were 51.92%and 93.10%,respectively.The AUC of IL-17A was 0.654[95%CI(0.540~0.756)],the optimal cut-off value was 4.38 pg/ml,and the sensitivity and specificity were 61.54%and 68.97%,respectively.The AUC of the combination was 0.834[95%CI(0.735~0.908)],and the difference was statistically significant compared with that of single detection(P<0.05).Conclusion FeNO combined with serum IL-17A detection has certain clinical significance for the evaluation and treatment of chronic cough.