血清ORMDL3结合FeNO对哮喘稳定期急性发作的预测分析

Predictive analysis of serum ORMDL3 combined with FeNO on acute attack of stable asthma

目的 分析血清类黏蛋白1样蛋白3(ORMDL3)结合呼出气一氧化氮(FeNO)对哮喘稳定期急性发作的预测价值。方法 选择2018年7月—2023年8月在本院门诊随访的120例哮喘稳定期患者作为疾病组,另同期选取120名健康体检者作为对照组,检测两组ORMDL3 mRNA表达量和FeNO浓度。依据疾病组3个月内是否出现哮喘急性发作将其分为急性发作组和非急性发作组,比较两组患者ORMDL3 mRNA表达量和FeNO浓度,采用多因素Logistic回归分析哮喘稳定期急性发作的影响因素,采用受试者工作特征(ROC)曲线分析ORMDL3 mRNA、FeNO单项及联合对哮喘稳定期急性发作的预测价值。结果 疾病组ORMDL3 mRNA表达量、FeNO浓度均高于对照组(P<0.05);急性发作组ORMDL3 mRNA表达量、FeNO浓度、体质量指数(BMI)以及吸烟史占比均高于非急性发作组(P<0.05),淋巴细胞计数、用力肺活量占预计值百分比(FVC%)、第一秒用力呼气末容积占预计值百分比(FEV1%)低于非急性发作组(P<0.05);经多因素Logistic回归分析显示,高ORMDL3 mRNA、高FeNO、高BMI均为哮喘稳定期患者急性发作的危险因素(P<0.05),高FVC%、高FEVI%为其保护因素(P<0.05)。ORMDL3 mRNA、FeNO联合预测哮喘稳定期患者急性发作的灵敏度高于单独预测,联合预测的AUC高于单独预测(P<0.05),联合预测的特异度与单独预测相近。结论 ORMDL3、FeNO均在哮喘稳定期急性发作患者中存在异常高表达,均是哮喘稳定期急性发作的影响因素,且两者联合对哮喘稳定期急性发作具有较好的预测价值。

Objective To analyze the predictive value of serum orosomucoid 1-like 3(ORMDL3)combined with exhaled nitric oxide(FeNO)in acute exacerbation of stable asthma.Methods 120 patients with stable asthma who were followed up in the outpatient department of our hospital from July 2018 to August 2023 were selected as the disease group,and 120 healthy subjects were selected as the control group at the same time.The expression of ORMDL3 mRNA and FeNO concentration were detected in the two groups.The disease group was divided into the acute attack group and the non-acute attack group according to whether there was acute attack of asthma within 3 months.The expression of ORMDL3 mRNA and FeNO concentration were compared between the two groups.The influencing factors of acute attack of asthma in stable stage were analyzed using multivariate Logistic regression analysis.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of ORMDL3 mRNA,FeNO and their combination on acute attack of asthma in stable stage.Results The expression of ORMDL3 mRNA and FeNO concentration in the disease group were higher than those in the control group(P<0.05).The expression of ORMDL3 mRNA,FeNO concentration,body mass index(BMI)and the proportion of smoking nistory in the acute attack group were higher than those in the non-acute attack group(P<0.05),and the lymphocyte count,forced vital capacity percentage of predicted value(FVC%)and forced expiratory volume in the first second percentage of predicted value(FEV1%)were lower than those in the non-acute attack group(P<0.05).Multivariate Logistic regression analysis showed that high ORMDL3 mRNA,high FeNO and high BMI were risk factors for acute attack in patients with stable asthma(P<0.05),and high FVC%,high FEVI%were protective factors(P<0.05).The sensitivity of ORMDL3 mRNA and FeNO combined prediction of acute attack in patients with stable asthma was higher than that of single prediction,and the AUC of combined prediction was higher than that of single prediction(P<0.05).The specificity of combined prediction was similar with that of single prediction.Conclusions ORMDL3 and FeNO are abnormally high expressed in patients with acute attack of stable asthma,which are the influencing factors of acute attack of stable asthma,and the combination of ORMDL3 and FeNO has a good predictive value for acute attack of stable asthma.