FENO水平与呼吸道感染严重程度的相关性研究

探讨FeNO水平与呼吸道感染严重程度之间的关系。方法 本研究 采用瑞典尼尔斯(NIOX)品牌FeNO测定仪进行FeNO水平的测量。根据临床症状和辅助检查,将患者的感染严重程度分为轻、中、重三级,进而分析FeNO水平与感染严重程度之间的相关性。统计分析采用Spearman相关性分析,以P<0.05为差异具有统计学意义的标准。结果 研究显示,FeNO水平与呼吸道感染严重程度呈正相关(r=0.XX,P<0.05),即随着感染严重程度的增加,FeNO水平也相应升高。特别是在重度感染患者中,FeNO水平明显高于轻度和中度感染患者。结论 FeNO水平与呼吸道感染严重程度之间存在显著的正相关性,提示FeNO测定可作为评估呼吸道感染严重程度的一个有效生物标志物。 。

MMP9、FeNO以及血清IgE与儿童哮喘急性发作严重程度的相关性分析

目的研究呼出气一氧化氮(FeNO)、血清免疫球蛋白E(IgE)和基质金属蛋白酶9(MMP9)的水平与儿童哮喘急性发作之间的关系,为儿童哮喘的预防及治疗提供依据。方法选取沈阳市妇婴医院于2020年11月至2022年11月收治的98例支气管哮喘急性发作期儿童作为急性组,按照病情程度分成轻度组(n=32)、中度组(n=38)和重度组(n=28),按照2∶1的比例选出49例同期在门诊治疗的处于支气管哮喘缓解期的儿童作为缓解组,随机选取健康体检儿童49例作为健康对照组,分别对他们进行FeNO、MMP9和血清IgE及肺功能[用力肺活量(FVC)、1秒用力呼气量(FEV_(1))、FEV_(1)/FVC%、最大呼气流量(PEF)]检测。应用Pearson相关分析探讨哮喘急性发作期FeNO、MMP9及血清IgE和肺功能之间的联系,并对三者在支气管哮喘急性发作中的预测价值进行分析。结果急性组、缓解组和对照组的年龄、性别、体重指数和病程的比较,差异无统计学意义(P>0.05)。急性组FeNO、MMP9、血清IgE分别为(59.95±12.65)ppb、(4.87±1.44)pg/ml、(330.63±74.88)IU/ml,缓解组分别为(25.23±8.23)ppb、(1.21±0.02)pg/ml、(152.23±32.12)IU/ml,均高于对照组的(12.43±4.09)ppb、(0.53±0.24)pg/ml、(126.34±57.33)IU/ml,差异具有统计学意义(P<0.05)。急性期和缓解期FVC、FEV1、FEV1/FVC%、PEF均低于对照组,差异具有统计学意义(P<0.05)。支气管哮喘急性发作中度组FeNO、MMP9、血清IgE水平分别为(49.23±6.23)ppb、(1.21±0.02)pg/ml、(282.61±59.83)IU/ml,重度组分别为(67.43±10.09)ppb、(0.53±0.24)pg/ml、(356.49±70.82)IU/ml,均高于轻度组的(34.62±10.65)ppb、(4.87±1.44)pg/ml,(189.21±14.33)IU/ml,差异具有统计学意义(P<0.05)。在轻度组中FeNO、MMP9和血清IgE水平均较低,而在中度组中这些指标均较高,其中FVC、FEV_(1)、FEV_(1)/FVC%和PEF均较低,差异具有统计学意义(P<0.05)。FeNO以及MMP9与血清IgE水平呈正相关(P<0.05),FeNO、MMP9以及血清IgE水平与FVC、FEV_(1)、FEV_(1)/FVC%、PEF均呈负相关(P<0.05)。MMP9在支气管哮喘的诊断中表现出了显著的优势,当达到最大约登指数时,对应的截断值为1.17,曲线下面积(Area under curve,AUC)为0.83,敏感度和特异性也分别达到了90.13%和86.5%。结论支气管哮喘急性发作的儿童血清中的FeNO、MMP9以及血清IgE水平显著增高,随肺部功能恶化程度加重而上升,可能与支气管哮喘急性发作患儿肺功能损害程度有关。

FeNO联合TSLP对儿童咳嗽变异性哮喘与感染后咳嗽的鉴别价值及与小气道功能的关系

目的探究呼出气一氧化氮(FeNO)联合胸腺基质淋巴细胞生成素(TSLP)对儿童咳嗽变异性哮喘(CVA)与感染后咳嗽(PIC)的鉴别价值,并分析FeNO、TSLP与CVA病情、小气道功能的关系,为临床诊疗提供有利依据。方法选取2021年6月至2023年4月郑州大学第一附属医院儿科诊治收治的90例CVA患儿作为CVA组,另选取同期90例PIC患儿作为PIC组。比较两组患儿的临床资料和FeNO、TSLP水平,绘制受试者工作特征(ROC)曲线及曲线下面积(AUC)分析FeNO联合TSLP对CVA与PIC的鉴别价值;比较CVA不同病情严重程度和病情阶段患儿的小气道功能[FEF25(%)、FEF50(%)、FEF75(%)、FEF25~75(%)]和FeNO、TSLP水平,采用Spearman和Pearson相关系数法分析FeNO、TSLP与CVA小气道功能、病情阶段、病情严重程度的相关性。结果CVA组患儿的FeNO、TSLP水平明显高于PIC组,差异均有统计学意义(P<0.05);ROC分析结果显示,FeNO联合TSLP鉴别CVA与PIC的AUC最大(0.934),敏感度、特异度为87.78%、82.22%,明显高于各指标单独诊断(P<0.05);轻度组患儿的FEF25、FEF50、FEF75和FEF25~75>中度组>重度组,差异均有统计学意义(P<0.05);轻度组患儿的FeNO、TSLP水平<中度组<重度组,差异均有统计学意义(P<0.05);临床缓解期组患儿的FEF25、FEF50、FEF75、FEF25~75明显高于急性发作期组,FeNO、TSLP水平明显低于急性发作期组,差异均有统计学意义(P<0.05);Pearson相关系数法分析结果显示,FeNO、TSLP与FEF25、FEF50、FEF75、FEF25~75均呈负相关(P<0.05);Spearman相关系数法分析结果显示,FeNO、TSLP与病情阶段、病情严重程度均呈正相关(P<0.05)。结论与PIC患儿比较,CVA患儿FeNO、TSLP水平异常升高,其联合鉴别诊断CVA与PIC具有较高价值,且FeNO、TSLP水平与患儿病情、小气道功能密切相关。

143例儿童哮喘TSLP基因多态性与Eos、IgE及FeNO的关联性研究

目的探讨胸腺基质淋巴细胞生成素(thymic stromal lymphopoietin,TSLP)基因rs1837253、rs3806933位点多态性与儿童哮喘易感性及Eos、IgE、FeNO水平的相关性。方法选取143例哮喘儿童作为研究组,选取同期健康体检儿童112例作为对照组。采用MassARRAY SNP分型技术检测2个位点基因型,散射比浊法测定血清IgE水平,分析基因型及等位基因频率在2组间的分布差异,分析不同基因型对Eos、IgE及FeNO水平的影响。结果rs1837253等位基因及基因型频率、rs3806933等位基因频率在2组间分布无统计学差异(P>0.05);哮喘组rs3806933 CT基因型频率高于对照组,CC基因型频率低于对照组(P<0.05);与野生基因型相比,携带rs1837253 CT+CC和rs3806933 CT、CT+TT基因型的儿童患哮喘风险增高(CT+CC vs TT:OR=2.737,95%CI:1.514~4.945;CT vs CC:OR=2.058,95%CI:1.194~3.543:CT+TT vs CC:OR=1.843,95%CI:1.109~3.062)。哮喘组rs1837253位点3个基因型间Eos计数总体存在统计学差异(P<0.05,多重比较后矫正P>0.05),在对照组无统计学差异(P>0.05);2位点基因型间Eos%、IgE、FeNO及rs3806933基因型间Eos计数水平无统计学差异(P>0.05)。结论TSLP基因启动子区rs1837253、rs3806933位点多态性与儿童哮喘易感性有关,rs3806933CT基因型可能作为哮喘潜在的遗传标志物,rs1837253CT+CC、rs3806933CT+TT基因型是儿童患哮喘的风险因子;rs1837253位点多态性有影响血液Eos计数的趋势;2个SNPs与Eos%、血清IgE、FeNO水平无关。

Breath-by-breath measurement of exhaled ammonia by acetonemodifier positive photoionization ion mobility spectrometry via online dilution and purging sampling

Exhaled ammonia(NH_(3))is an essential noninvasive biomarker for disease diagnosis.In this study,an acetone-modifier positive photoionization ion mobility spectrometry(AM-PIMS)method was developed for accurate qualitative and quantitative analysis of exhaled NH_(3)with high selectivity and sensitivity.Acetone was introduced into the drift tube along with the drift gas as a modifier,and the characteristic NH_(3)product ion peak of(C_(3)H_(6)O)_(4)NH_(4)^(+)(K_(0)=1.45 cm^(2)/V·s)was obtained through the ion-molecule reaction with acetone reactant ions(C_(3)H_(6)O)_(2)H^(+)(K_(0)=1.87 cm^(2)/V·s),which significantly increased the peak-to-peak resolution and improved the accuracy of exhaled NH_(3)qualitative identification.Moreover,the interference of high humidity and the memory effect of NH_(3)molecules were significantly reduced via online dilution and purging sampling,thus realizing breath-by-breath measurement.As a result,a wide quantitative range of 5.87-140.92μmol/L with a response time of 40 ms was achieved,and the exhaled NH_(3)profile could be synchronized with the concentration curve of exhaled CO_(2).Finally,the analytical capacity of AM-PIMS was demonstrated by measuring the exhaled NH_(3)of healthy subjects,demonstrating its great potential for clinical disease diagnosis.

Diagnostic role of fractional exhaled nitric oxide in pediatric eosinophilic esophagitis, relationship with gastric and duodenal eosinophils

BACKGROUND Eosinophilic esophagitis(EoE)is an eosinophilic-predominant inflammation of the esophagus diagnosed by upper endoscopy and biopsies.A non-invasive and cost-effective alternative for management of EoE is being researched.Previous studies assessing utility of fractional exhaled nitric oxide(FeNO)in EoE were low powered.None investigated the contribution of eosinophilic inflammation of the stomach and duodenum to FeNO.AIM To assess the utility of FeNO as a non-invasive biomarker of esophageal eosinophilic inflammation for monitoring disease activity.METHODS Patients aged 6-21 years undergoing scheduled upper endoscopy with biopsy for suspected EoE were recruited in our observational study.Patients on steroids and with persistent asthma requiring daily controller medication were excluded.FeNO measurements were obtained in duplicate using a chemiluminescence nitric oxide analyzer(NIOX MINO,Aerocrine,Inc.;Stockholm,Sweden)prior to endoscopy.Based on the esophageal peak eosinophil count(PEC)/high power field on biopsy,patients were classified as EoE(PEC≥15)or control(PEC≤14).Mean FeNO levels were correlated with presence or absence of EoE,eosinophil counts on esophageal biopsy,and abnormal downstream eosinophilia in the stomach(PEC≥10)and duodenum(PEC≥20).Wilcoxon rank-sum test,Spearman correlation,and logistic regression were used for analysis.P value<0.05 was considered significant.RESULTS We recruited a total of 134 patients,of which 45 were diagnosed with EoE by histopathology.The median interquartile range FeNO level was 17 parts per billion(11-37,range:7-81)in the EoE group and 12 parts per billion(8-19,range:5-71)in the control group.After adjusting for atopic diseases,EoE patients had significantly higher FeNO levels as compared to patients without EoE(Z=3.33,P<0.001).A weak yet statistically significant positive association was found between the number of esophageal eosinophils and FeNO levels(r=0.30,P<0.005).On subgroup analysis within the EoE cohort,higher FeNO levels were noted in patients with abnormal gastric(n=23,18 vs 15)and duodenal eosinophilia(n=28,21 vs 14);however,the difference was not statistically significant.CONCLUSION After ruling out atopy as possible confounder,we found significantly higher FeNO levels in the EoE cohort than in the control group.

The IOMT-Based Risk-Free Approach to Lung Disorders Detection from Exhaled Breath Examination

The lungs are the main fundamental part of the human respiratory system and are among the major organs of the human body.Lung disorders,including Coronavirus(Covid-19),are among the world’s deadliest and most life-threatening diseases.Early and social distance-based detection and treatment can save lives as well as protect the rest of humanity.Even though X-rays or Computed Tomography(CT)scans are the imaging techniques to analyze lung-related disorders,medical practitioners still find it challenging to analyze and identify lung cancer from scanned images.unless COVID-19 reaches the lungs,it is unable to be diagnosed.through these modalities.So,the Internet of Medical Things(IoMT)and machine learning-based computer-assisted approaches have been developed and applied to automate these diagnostic procedures.This study also aims at investigating an automated approach for the detection of COVID-19 and lung disorders other than COVID-19 infection in a non-invasive manner at their early stages through the analysis of human breath.Human breath contains several volatile organic compounds,i.e.,water vapor(5.0%–6.3%),nitrogen(79%),oxygen(13.6%–16.0%),carbon dioxide(4.0%–5.3%),argon(1%),hydro-gen(1 ppm)(parts per million),carbon monoxide(1%),proteins(1%),isoprene(1%),acetone(1%),and ammonia(1%).Beyond these limits,the presence of a certain volatile organic compound(VOC)may indicate a disease.The proposed research not only aims to increase the accuracy of lung disorder detection from breath analysis but also to deploy the model in a real-time environment as a home appliance.Different sensors detect VOC;microcontrollers and machine learning models have been used to detect these lung disorders.Overall,the suggested methodology is accurate,efficient,and non-invasive.The proposed method obtained an accuracy of 93.59%,a sensitivity of 89.59%,a specificity of 94.87%,and an AUC-Value of 0.96.

In-situ measurement via the flow-through method and numerical simulations for radon exhalation during measurements of the radon exhalation rate

Small-scale measurements of the radon exhalation rate using the flow-through and closed-loop methods were conducted on the surface of a uranium tailing pond to better understand the differences between the two methods.An abnormal radon exhalation behavior was observed,leading to computational fluid dynamics(CFD)-based simulations in which dynamic radon migration in a porous medium and accumulation chamber was considered.Based on the in-situ experimental and numerical simulation results,variations in the radon exhalation rate subject to permeability,flow rate,and insertion depth were quantified and analyzed.The in-situ radon exhalation rates measured using the flow-through method were higher than those measured using the closed-loop method,which could be explained by the negative pressure difference between the inside and outside of the chamber during the measurements.The consistency of the variations in the radon exhalation rate between the experiments and simulations suggests the reliability of CFD-based techniques in obtaining the dynamic evolution of transient radon exhalation rates for diffusion and convection at the porous medium-air interface.The synergistic effects of the three factors(insertion depth,flow rate,and permeability)on the negative pressure difference and measured exhalation rate were quantified,and multivariate regression models were established,with positive correlations in most cases;the exhalation rate decreased with increasing insertion depth at a permeability of 1×10^(−11) m^(2).CFD-based simulations can provide theoretical guidance for improving the flow-through method and thus achieve accurate measurements.

Numerical simulations for radon migration and exhalation behavior during measuring radon exhalation rate with closed-loop method

Accurate measurements of the radon exhalation rate help identify and evaluate radon risk regions in the environment.Among these measurement methods,the closed-loop method is frequently used.However,traditional experiments are insufficient or cannot analyze the radon migration and exhalation patterns at the gas–solid interface in the accumulation chamber.The CFD-based technique was applied to predict the radon concentration distribution in a limited space,allowing radon accumulation and exhalation inside the chamber intuitively and visually.In this study,three radon exhalation rates were defined,and two structural ventilation tubes were designed for the chamber.The consistency of the simulated results with the variation in the radon exhalation rate in a previous experiment or analytical solution was verified.The effects of the vent tube structure and flow rate on the radon uniformity in the chamber;permeability,insertion depth,and flow rate on the radon exhalation rate and the effective diffusion coefficient on back-diffusion were investigated.Based on the results,increasing the inser-tion depth from 1 to 5 cm decreased the effective decay constant by 19.55%,whereas the curve-fitted radon exhalation rate decreased(lower than the initial value)as the deviation from the initial value increased by approximately 7%.Increasing the effective diffusion coefficient from 2.77×10^(-7) to 7.77×10^(-6) m^(2) s^(-1) made the deviation expand from 2.14 to 15.96%.The conclusion is that an increased insertion depth helps reduce leakage in the chamber,subject to notable back-diffusion,and that the closed-loop method is reasonably used for porous media with a low effective diffusion coefficient in view of the back-diffusion effect.The CFD-based simulation is expected to provide guidance for the optimization of the radon exhalation rate measurement method and,thus,the accurate measurement of the radon exhalation rate.

FeNO联合肺功能监测在小儿支气管哮喘中的诊断及治疗指导作用分析

目的探讨呼出气一氧化氮(FeNO)联合肺功能监测指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)及第1秒用力呼气容积占用力肺活量百分比(FEV1/FVC%)]在小儿支气管哮喘中诊断及治疗指导中的作用。方法选取2021年9月-2023年5月在我院就诊的40例小儿支气管哮喘患儿为研究组,另选取我院40例健康体检儿童对照组;对比2组入院时FeNO及肺功能指标水平;ROC分析FeNO及肺功能指标联合测定对支气管哮喘患儿的诊断价值;对比不同临床疗效支气管哮喘患儿治疗7d时、15d、30d时FeNO及肺功能指标水平;分析FeNO及肺功能指标与临床疗效的相关性。结果入院时研究组肺功能指标水平显著低于对照组,FeNO水平显著高于对照组(P<0.05);入院时FeNO与肺功能指标联合诊断支气管哮喘的AUC为0.741;治疗有效患者治疗7d时、15d时、30d时FeNO水平显著低于治疗无效患者,肺功能指标显著高于治疗无效患者(P<0.05);支气管哮喘患儿FeNO与临床疗效呈正相关、肺功能指标与临床疗效呈负相关(P<0.05)。结论FeNO和肺功能指标联合检测对诊断小儿支气管哮喘具有重要价值,同时对临床治疗具有重要指导作用。

胸闷变异性哮喘FeNO水平对支气管激发实验结果的影响研究

深入研究胸闷的哮喘患者,其中受到重点关注的是呼出的一氧化氮(FeNO)水平与吹出气力肺活量(FEV1)的预计百分代数,以及咳嗽症状评分之间的相关性。方法 选择了120例可能患有咳嗽型哮喘的患者,对他们进行分类,治疗有效的51例标记为A组,而无效的69例记为B组。研究人员仔细比较了两组患者治疗前后的FeNO水平、FEV1的预计百分比、用药引发的痰EOS百分比以及咳嗽症状评分。采用的统计方法是独立样本T检验去分析平均数的差异,如果P值小于0.01就认为差异显著。结果 在开始治疗之前,效果显著的A组在FeNO水平、痰EOS百分比和咳嗽症状评分这三项指标上显著优于B组,而且在治疗后这三项指标都有显著的下降。结论 胸闷变异性哮喘患者FeNO水平与咳嗽症状有显著关联性,语监测FeNO水平有助于评估治疗效果,为临床提供辨识咳嗽变异性哮喘患者的有效方法。

藏族慢性阻塞性肺疾病急性加重期患者伴高FeNO水平的临床预测因素

目的 探讨藏族慢性阻塞性肺疾病急性加重期(AECOPD)患者呼出气一氧化氮(FeNO)水平增高的临床预测因素。方法 回顾性收集2018年6月-2023年2月三六三医院收治的藏族AECOPD患者FeNO水平,及其人口学特征、生活环境、个人史、家族史、肺功能和血检指标。将患者分为高FeNO组(FeNO>25ppb)和低FeNO组(FeNO≤25ppb),行单因素组间比较,选取差异性变量,进一步采用广义倾向性得分加权分析,评价其与FeNO水平的关联程度。结果 共235例藏族AECOPD患者纳入本次研究,其中高FeNO组71例(30.2%),低FeNO组164例(69.8%)。单因素分析提示,与低FeNO组相比,高FeNO组患者生物燃料的使用时间更长(P<0.001)、目前使用生物燃料者的占比更高(P<0.001),外周血嗜酸性粒细胞(EOS)计数更高(P=0.040),C反应蛋白(CRP)水平更低(P=0.045),目前吸烟人数占比更低(P=0.011),居住海拔更低(P=0.016)。广义倾向性得分加权分析进一步显示,高FeNO组患者目前使用生物燃料者的占比更高(P<0.001),外周血EOS计数更高(P=0.032),身高更高(P=0.016),年龄更大(P=0.037);目前吸烟人数占比更低(P=0.001),居住海拔更低(P=0.023)。结论 本研究发现在藏族AECOPD患者中,使用生物燃料、外周血高EOS计数、较高身材、更大年龄,而非目前吸烟和居住高海拔,可能是高FeNO水平的临床预测因素。

FeNO_(50)+CaNO联合检测对慢性阻塞性肺疾病急性加重期激素治疗的应用价值

目的:探讨呼出气流速为50 mL·s^(-1)时呼出气一氧化氮(FeNO_(50))+肺泡呼出气一氧化氮(CaNO)联合检测对慢性阻塞性肺疾病急性加重期(AECOPD)患者使用糖皮质激素治疗的应用价值。方法:前瞻性地纳入2021年6月1日至2023年5月31日在深圳市第二人民医院呼吸与危重症医学科住院的AECOPD患者62例。根据入院时FeNO_(50)、CaNO水平分为4组(Ⅰ组:FeNO_(50)<25 ppb,CaNO≤5 ppb;Ⅱ组:FeNO_(50)≥25 ppb,CaNO≤5 ppb;Ⅲ组:FeNO_(50)<25 ppb,CaNO>5 ppb;Ⅳ组:FeNO_(50)≥25 ppb,CaNO>5 ppb)。对所有患者使用全身糖皮质激素治疗。分别记录入院时及出院时的FeNO_(50)水平、CaNO水平、外周血嗜酸性粒细胞(EOS)、肺功能[第1秒用力呼气容积(FEV1)]、慢性阻塞性肺疾病评估测试(CAT)评分。使用Pearson相关性分析EOS、FeNO_(50)、CaNO三者关系,比较4组间FEV1、CAT评分治疗前后的改善值变化情况;采用受试者工作特征曲线(ROC)分析FeNO_(50)、CaNO、EOS对治疗后肺功能改善的预测价值。结果:各组患者的年龄、性别、身体质量指数(BMI)、吸烟史及平素症状之间比较,差异无统计学意义(P>0.05)。Pearson分析提示入院时EOS与FeNO_(50)呈正相关(r=0.521,P<0.05);经过治疗,EOS改善值与FeNO_(50)改善值呈正相关(r=0.472,P<0.05)。经全身糖皮质激素治疗后,4组间FEV1改善值、CAT评分改善值差异均有统计学意义(P<0.001;P=0.002);Ⅳ组患者较其他三组FEV1改善值更明显,差异有统计学意义(P<0.05),Ⅲ组和Ⅳ组患者较其他两组CAT评分改善更明显,差异有统计学意义(P<0.05)。ROC曲线下面积未观察到EOS、FeNO_(50)、CaNO对AECOPD患者治疗后肺功能显著改善有明显预测价值。结论:FeNO_(50)+CaNO联合检测对AECOPD患者使用全身糖皮质激素疗效具有一定的预测作用,FeNO_(50)与CaNO均升高的患者经全身糖皮质激素治疗后肺功能的改善更明显,而CANO升高的患者治疗后症状的改善更明显,但有待扩大样本量进一步验证。

FeNO在睡眠呼吸障碍中的临床应用及其监测价值探讨

运用实验研究方法探讨FeNO在睡眠呼吸障碍中的临床应用及其监测价值。方法 选取80个睡眠呼吸障碍患者进行研究,将他们分为基线期和使用Airmini期两个阶段,对比观察其呼吸干扰指数(AHI)、打鼾时间占比以及氧减指数的变化情况。 结果 从表1中可看出,AHI在基线期平均值为37.22,使用Airmini期降至3.13,差值达到34.09,两组间有显著性差异(p<0.001)。标准偏差分别为22.94(基线期)和1.42(Airmini期),显示出Airmini期患者在呼吸障碍上更稳定。表2中打鼾时间占比,在基线期平均为0.19,AirMini期则降至0.01,差值达0.18,同样有显著性差异 (p<0.05)。在表3中氧减指数在基线期平均值为40.65,使用Airmini期降至4.86,差值达35.79,两组间也存在显著差异 (p<0.001)。结论 FeNO的临床应用在处理睡眠呼吸障碍上有显著效果,Airmini在控制呼吸障碍、减少打鼾时间和改善氧饱和度都显示出较高的效果,验证了FeNO在睡眠呼吸障碍中的监测价值。

睡眠呼吸障碍患者中FeNO水平及其与病情严重程度的关系分析

通过睡眠呼吸障碍患者的sRAGE、esRAGE、cRAGE含量和AHI的比较,探讨FeNO水平及其与病情严重程度的关系。方法 我们将患者分为三组:III期,IV期,与V期,并多项对比这三组患者的一般信息与血清指标。结果 数据显示,从III到V期,T2DM病程、24h尿微量白蛋白、Scr均逐渐增高。同时,sRAGE、esRAGE、cRAGE含量和AHI也表现出同样的趋势。所有差异P值均<0.015,提示这些血清指标的变化与病情严重程度相关。结论 我们的研究发现,随病程延长和病情加重,FeNO水平显著提高,AHI也呈现逐渐增高的趋势,提示睡眠呼吸障碍程度,特别是sRAGE、cRAGE、esRAGE含量可能与FeNO水平有关,为睡眠呼吸障碍的研究提供了新的理论依据。

临床控制哮喘与咳嗽变异性哮喘的小气道功能及FeNO变化差异分析

目的:探究临床控制哮喘(CCA)与咳嗽变异性哮喘(CVA)的小气道功能及呼出气一氧化氮(FeNO)变化差异,并分析各指标对CCA与CVA的鉴别诊断价值。方法:选取2021年1月—2023年12月厦门市海沧医院的51例CCA与51例CVA患者的病历资料进行回顾性分析,比较两组肺通气功能指标[用力肺活量占预计值百分比(FVC%pred)、第1秒用力呼气量占预计值百分比(FEV1%pred)、呼气峰值流量占预计值百分比(PEF%pred)]、小气道功能指标[中段呼气流量占预计值百分比(FEF_(25%~75%)%pred)、75%和50%用力肺活量时的呼吸流速占预计值百分比(FEF_(75%)%pred和FEF_(50%)%pred)]及FeNO,采用Pearson相关性分析各组FeNO与气道功能指标的关系,采用受试者操作特征(ROC)曲线分析FeNO与小气道功能指标对CVA的诊断价值。结果:与CCA组比较,CVA组FEV_(1)%pred、PEF%pred、FEF_(25%~75%)%pred、FEF_(50%)%pred、FEF_(75%)%pred均较低,FeNO指标较高,差异均有统计学意义(P<0.05)。Pearson相关性结果显示,CCA组与CVA组气道功能指标与FeNO指标均呈负相关(P<0.05)。ROC曲线结果显示,FEF_(25%~75%)%pred、FEF_(50%)%pred、FEF_(75%)%pred和FeNO诊断CVA的AUC分别为0.824、0.836、0.790、0.793,均有一定的诊断价值(P<0.001),但各指标之间AUC值比较差异均无统计学意义(P>0.05)。结论:相较于CCA患者,CVA患者的小气道功能较差,FeNO较高,且FEF_(25%~75%)%pred、FEF_(50%)%pred、FEF_(75%)%pred和FeNO对CVA有一定的诊断价值。

FeNO检测在胸闷变异性哮喘诊断中的应用研究

研究在胸闷变异性哮喘诊断中应用吸入一氧化氮(FeNO)检测的效果。方法 选择120例可疑咳嗽变异性哮喘患者,按照治疗后效果好坏,将其分为有效组(51例)和无效组(69例)。比较和分析两组患者治疗前的各项指标,包括一氧化氮(FeNO)水平、预计肺活量占预测值的百分比(FEV1)、诱导痰中嗜酸性粒细胞(EOS)百分比、咳嗽症状评分,然后观察治疗后各项指标的变化。结果 通过对比发现,有效组治疗前的FeNO水平和EOS百分比明显高于无效组,诱导痰EOS百分比和咳嗽症状评分显著降低。治疗后,有效组的FeNO水平下降百分比、诱导痰EOS百分比下降百分比以及咳嗽症状评分下降百分比均显著超过无效组。结论 FeNO检测作为一种无创检测方法,在胸闷变异性哮喘的诊断中具有良好应用价值,特别是对于治疗效果的评估具有显著的指导价值,值得在临床上进一步推广应用。

反复呼吸道感染患儿FeNO水平与肺功能、Th1/Th2平衡的关系

目的 分析反复呼吸道感染患儿呼出气一氧化氮(FeNO)水平与肺功能、辅助性T细胞1(Th1)/辅助性T细胞2(Th2)(Th1/Th2)平衡的关系。方法 选择2021年10月至2023年10月宣城市中心医院收治的83例反复呼吸道感染患儿作为研究组,另选同期普通呼吸道感染住院患儿95例作为对照组。所有纳入对象入院后24 h内检测FeNO水平及肺功能指标第一秒用力呼气容积(FEV1)、FEV1与用力肺活量比值(FEV1/FVC)、峰值呼气流量(PEF),同时利用流式细胞仪检测Th1、Th2细胞水平,并计算Th1/Th2比值,采用酶联免疫吸附法检测血清γ-干扰素(IFN-γ)、白细胞介素-4(L-4),并进行组间比较。采用Pearson相关性分析反复呼吸道感染患儿FeNO水平与FEV1%、FEV1/FVC、PEF%、Th1/Th2,以及IFN-γ、IL-4与FeNO、FEV1、FEV1/FVC、PEF、Th1/Th2的关系。结果 研究组患儿FeNO水平明显高于对照组,差异有统计学意义(P<0.05)。研究组患儿FEV1、FEV1/FVC、PEF均明显低于对照组,差异有统计学意义(P<0.05)。研究组患儿外周血Th2细胞水平明显高于对照组,差异有统计学意义(P<0.05)。研究组患儿外周血Th1细胞水平、Th1/Th2均明显低于对照组,差异有统计学意义(P<0.05)。研究组患儿血清IFN-γ、IL-4水平均明显高于对照组,差异有统计学意义(P<0.05)。相关性分析显示,反复呼吸道感染患儿FeNO水平与FEV1、FEV1/FVC、PEF及Th1/Th2均呈负相关(均P<0.05)。血清IFN-γ、IL-4与FeNO水平均呈正相关(均P<0.05),与FEV1、FEV1/FVC、PEF及Th1/Th2均呈负相关(均P<0.05)。结论 反复呼吸道感染患儿FeNO水平明显升高,且高FeNO水平与肺功能降低、Th1/Th2免疫失衡密切相关,其之间的相互作用共同影响反复呼吸道感染患儿疾病发生发展。

慢阻肺患者外周血EOS与FeNO水平及肺功能的相关性分析

目的对慢性阻塞性肺疾病(慢阻肺)患者外周血嗜酸性粒细胞(EOS)与呼出气一氧化氮(FeNO)水平及肺功能的相关性进行分析。方法选取2019年10月至2023年6月徐州市第一人民医院收治的200例慢阻肺患者作为研究对象,并设为观察组。其中男138例,女62例;年龄55~88(66.45±5.45)岁;病程1~18(10.23±3.23)年。根据疾病分期,将观察组患者分为急性发作组(150例)和稳定期组(50例)。另选取同期住院的100例非慢阻肺患者作为对照组。收集300例受试者的一般资料,如吸烟史、饮酒史、基础疾病及体重指数(BMI)等。采用全自动血细胞分析仪检测EOS水平,采用FeNO检测仪检测FeNO水平,采用肺功能检测仪检测肺功能。采用Pearson相关分析法分析慢阻肺患者外周血EOS与FeNO水平及肺功能的相关性。采用独立样本t检验、F检验和χ^(2)检验。结果观察组吸烟史人数占比[52.50%(105/200)]高于对照组[17.00%(17/100)](P<0.05)。稳定期组和急性发作组外周血EOS[(6.23±0.21)%、(6.42±0.58)%]与FeNO[(35.52±7.28)ppb、(46.28±7.08)ppb]水平均高于对照组[(2.23±0.59)%、(15.23±7.34)ppb],且急性发作组FeNO水平高于稳定期组(均P<0.05)。稳定期组和急性发作组用力肺活量(FVC)[(2.18±0.18)L、(2.16±0.15)L]、第1秒用力呼气容积(FEV1)[(1.16±0.31)L、(1.14±0.28)L]、FEV1/FVC[(60.56±8.24)%、(59.23±8.21)%]及FEV1%[(65.23±8.59)%、(64.11±8.12)%]均低于对照组[(3.16±0.38)L、(2.21±0.41)L、(82.28±9.16)%、(89.62±5.23)%](均P<0.05)。Pearson相关性分析显示,慢阻肺患者外周血EOS水平与FeNO水平呈正相关(r=0.584,P=0.002),与FEV1/FVC呈负相关(r=-0.213,P=0.005)。结论慢阻肺患者外周血EOS与FeNO水平及肺功能存在明显相关性,临床可根据其水平变化来判断患者病情,并为后期治疗提供一定的指导。

血清ORMDL3结合FeNO对哮喘稳定期急性发作的预测分析

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。