Hs-CRP,NLR水平联合呼出气一氧化氮检测在支气管哮喘急性发作期患儿诊断及病情评估中的应用

Application of Hs-CRP and NLR levels combined with exhaled nitric oxide detection in the diagnosis and assessment of acute exacerbation of bronchial asthma in children

目的探索高敏C-反应蛋白(Hs-CRP)、中性粒细胞/淋巴细胞比值(NLR)水平联合呼出气一氧化氮(FeNO)检测在支气管哮喘(BA)急性发作期患儿诊断及病情评估中的应用。方法选取2020年10月-2023年12月收治的92例BA急性发作期患儿作为急性发作组,选择同期48例缓解期BA患儿作为缓解组,52例常规体检的健康儿童作为正常组。依据患儿病情严重程度分为轻度组(n=34)、中度组(n=35)、重度组(n=23)。收集三组儿童的一般资料,分析三组患儿Hs-CRP、NLR、FeNO水平及肺功能指标。采用受试者工作特征(ROC)曲线分析Hs-CRP、NLR联合FeNO水平对BA患儿急性发作期的诊断价值,分析不同病情严重程度BA患儿Hs-CRP、NLR、FeNO水平及肺功能指标,分析Hs-CRP、NLR、FeNO水平及肺功能指标与BA急性发作患儿病情的相关性。结果急性发作组患儿Hs-CRP、NLR、FeNO水平高于正常组及缓解组(F=97.989,85.801,75.922,P均<0.001),肺功能指标水平低于缓解组患儿(t=5.388,4.882,12.331,P<0.001),Hs-CRP、NLR联合FeNO水平诊断BA患儿急性发作期的诊断价值优于单个指标单独诊断(P<0.05),急性发作组不同病情严重程度BA患儿Hs-CRP、NLR、FeNO水平逐渐升高(F=20.250,13.481,15.428,P均<0.001),肺功能指标水平逐渐降低(F=25.117,13.610,57.360,P均<0.001),BA患儿病情严重程度与Hs-CRP、NLR、FeNO水平呈正相关,与肺功能指标呈负相关(P均<0.001)。结论急性发作期BA患儿Hs-CRP、NLR、FeNO水平升高,联合诊断BA患儿急性发作期的价值较高,可辅助临床评估BA患儿的病情。

Objective To explore the application of high sensitivity C-reactive protein(Hs-CRP),neutrophil/lymphocyte ratio(NLR)levels combined with exhaled nitric oxide(FeNO)detection in the diagnosis and assessment of acute exacerbation of bronchial asthma(BA)in children.Methods A total of 92 children with acute exacerbation of BA admitted between October 2020 and December 2023 were regarded as the acute attack group,48 children with remission of BA were used as the remission group,and 52 healthy children who underwent routine physical examination were the normal group.According to the severity of the patient′s condition,they were separated into a mild group(34 cases),moderate group(35 cases),and severe group(23 cases).The general data of the children in the three groups were collected,and the Hs-CRP,NLR,FeNO levels,and lung function indexes of the children in the three groups were analyzed.The diagnostic value of Hs-CRP,NLR combined with FeNO levels in children with BA during acute exacerbation was analyzed by using the subject′s work characteristic(ROC)curve,and the correlation of Hs-CRP,NLR,FeNO levels,and lung function indexes in children with BA of different severity with the condition of children with acute exacerbation of BA was analyzed.Results The levels of Hs-CRP,NLR,and FeNO in the acute attack group were higher than those in the normal group and remission group(F=97.989,85.801,75.922,P<0.001),the levels of lung function indicators in the remission group were lower than in the remission group(t=5.388,4.882,12.331,P<0.001),the diagnostic value of Hs-CRP,NLR combined with FeNO levels in diagnosing acute exacerbations of BA in children was superior to that of single indicator diagnosis alone(P<0.05),the levels of Hs-CRP,NLR,and FeNO gradually increased in BA patients with different severity levels in the acute attack group(F=20.250,13.481,15.428,P<0.001),the level of lung function indicators gradually decreased(F=25.117,13.610,57.360,P<0.001),the severity of BA in children was positively correlated with Hs-CRP,NLR,and FeNO levels,and negatively correlated with lung function indicators(P<0.001).Conclusion The levels of Hs-CRP,NLR,and FeNO are elevated in children with BA during acute exacerbation,and the combined diagnosis of BA during acute exacerbation has a high value,which can assist in the clinical evaluation of the condition of BA patients.