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1、第48卷第10期山东大学学报(医学版)2010年10月Vo.l48No.10JOURNALOFSHANDONGUNIVERSITY(HEALTHSCIENCES)Oc.t2010文章编号:1671-7554(2010)10-0081-04呼出气一氧化氮检测对支气管哮喘的诊断价值121柴静,蒋萍,钱雪娇(1.天津医科大学研究生院,天津300070;2.天津市第一中心医院呼吸科,天津300192)摘要:目的评价呼出气一氧化氮(FeNO)检测在支气管哮喘诊断中的意义。方法哮喘非特异症状患者118例,其中支气管
2、哮喘患者71例为A组,首次诊断为支气管哮喘患者52例为组,规律应用吸入性糖皮质激素达4周以上的支气管哮喘患者19例为组,其余47例非哮喘患者为B组。采用NIOXNO测定仪测定FeNO水平,以2006年GINA标准为诊断支气管哮喘的金标准,绘制受试者工作曲线(ROC),评价FeNO对支气管哮喘鉴别诊断的价值,明确FeNO的诊断临界点。结果组FeNO高于组[(72.92!50.26)ppb比(35.74!27.53)ppb,P﹤0.05]和B组[(72.92!50.26)ppb比(17.62!9.77)ppb,P﹤0.05]。排除糖皮质激素对FeNO的
3、影响,以组和B组患者为观察对象,ROC曲线下面积为0.90,最佳临界点为32.50ppb,以该点为阈值,诊断哮喘的敏感度为82.70%,特异度为87.90%。结论FeNO对哮喘的诊断具有较高的敏感性和特异性。关键词:哮喘;一氧化氮;诊断;诊断,鉴别;ROC曲线中图分类号:R562.2文献标志码:ADiagnosticvalueoffractionalexhalednitricoxidemeasurementinbronchialasthma121CHAIJing,JIANGPing,QIANXuejiao(1.TianjinMedicalUn
4、iversity,Tianjin300070,China;2.DepartmentofRespiratoryMedicine,TianjinFirstCentralHospita,lTianjin300192,China)Abstract:ObjectiveToexplorethediagnosticvalueoffractionalexhalednitricoxide(FeNO)measurementinthediagnosisofbronchialasthma.MethodsAtotalof118patientswithnonspecificr
5、espiratorysymptomswereenrolled.71caseswerediagnosedasbronchialasthma(groupA).52casesdidnotreceivedatreatmentwithglucocorticoids(group)and19casesreceiveditformorethan4weeks(group).47caseswerediagnosedasnonasthma(groupB).FeNOwasmeasuredbyanitricoxideanalyzer(NIOX;AerocrineAB;Sol
6、na,Sweden).GINA(2006)wasdefinedasthegoldstandardinthediagnosisofbronchialasthma.ThevalueofFeNOwasassessedandtheoptimaloperatingpointoftheFeNOtestingwasdeterminedbythemeansofthereceiveroperatingcharacteristic(ROC)curves.ResultsLevelofFeNOingroupwashigherthanthatingroup[(72.92!5
7、0.26)ppbvs(35.74!27.53)ppb,P﹤0.05]andgroupB[(72.92!50.26)ppbvs(17.62!9.77)ppb,P﹤0.05].TheareaundertheROCcurvewas0.90.Theoptimaldiagnosticcutoffpointwas32.50ppb,whichwascapableofdifferentiatingasthmaandnonasthmawithasensitivityof82.70%andaspecificityof87.90%.ConclusionTheFeNOt
8、estmaybehelpfulinthediagnosisofasthmawit
