国际儿科学杂志
國際兒科學雜誌
국제인과학잡지
International Journal of Pediatrics
2015年
6期
685-688
,共4页
呼出气一氧化氮%乙酰甲胆碱支气管激发试验%哮喘%儿童
呼齣氣一氧化氮%乙酰甲膽堿支氣管激髮試驗%哮喘%兒童
호출기일양화담%을선갑담감지기관격발시험%효천%인동
Exhaled nitric oxide%Methacholine bronchial provocation test%Asthma%Children
目的 分析哮喘患儿呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)水平与支气管激发试验结果的相关性,探讨应用FeNO预测哮喘患儿气道高反应性.方法 选取于中国医科大学附属盛京医院儿童哮喘门诊就诊的114例初诊哮喘患儿,进行呼出气一氧化氮、肺功能和乙酰甲胆碱为激发剂的支气管激发试验检查.为明确FeNO是否能对支气管激发试验结果有预测作用,绘制FeNO水平与支气管激发试验间的ROC曲线.结果 支气管激发试验阳性组33例,阴性组81例,支气管激发试验阳性组的FeNO值为19.0×10-9(13.5×10-9～49.0×10-9),阴性组的FeNO值为16.0×10-9(12.0×10-9～24.0×10-9),两组间差异有统计学意义(P=0.000);由ROC曲线,得出FeNO预测支气管激发试验结果阳性的界值点(cut off point)为38.5×10-9,其检验敏感性为36.4％,特异性为92.6％.FeNO值与FEV1下降20％时吸入的乙酰甲胆碱累积计量(PD20-FEV1)之间不存在剂量相关性.结论 FeNO水平对支气管激发试验结果有一定的预测作用.当FeNO水平＞38.5 ×10-9时可以预测支气管激发试验结果为阳性的准确性较高,提示患儿存在气道高反应性.
目的 分析哮喘患兒呼齣氣一氧化氮(fractional exhaled nitric oxide,FeNO)水平與支氣管激髮試驗結果的相關性,探討應用FeNO預測哮喘患兒氣道高反應性.方法 選取于中國醫科大學附屬盛京醫院兒童哮喘門診就診的114例初診哮喘患兒,進行呼齣氣一氧化氮、肺功能和乙酰甲膽堿為激髮劑的支氣管激髮試驗檢查.為明確FeNO是否能對支氣管激髮試驗結果有預測作用,繪製FeNO水平與支氣管激髮試驗間的ROC麯線.結果 支氣管激髮試驗暘性組33例,陰性組81例,支氣管激髮試驗暘性組的FeNO值為19.0×10-9(13.5×10-9～49.0×10-9),陰性組的FeNO值為16.0×10-9(12.0×10-9～24.0×10-9),兩組間差異有統計學意義(P=0.000);由ROC麯線,得齣FeNO預測支氣管激髮試驗結果暘性的界值點(cut off point)為38.5×10-9,其檢驗敏感性為36.4％,特異性為92.6％.FeNO值與FEV1下降20％時吸入的乙酰甲膽堿纍積計量(PD20-FEV1)之間不存在劑量相關性.結論 FeNO水平對支氣管激髮試驗結果有一定的預測作用.噹FeNO水平＞38.5 ×10-9時可以預測支氣管激髮試驗結果為暘性的準確性較高,提示患兒存在氣道高反應性.
목적 분석효천환인호출기일양화담(fractional exhaled nitric oxide,FeNO)수평여지기관격발시험결과적상관성,탐토응용FeNO예측효천환인기도고반응성.방법 선취우중국의과대학부속성경의원인동효천문진취진적114례초진효천환인,진행호출기일양화담、폐공능화을선갑담감위격발제적지기관격발시험검사.위명학FeNO시부능대지기관격발시험결과유예측작용,회제FeNO수평여지기관격발시험간적ROC곡선.결과 지기관격발시험양성조33례,음성조81례,지기관격발시험양성조적FeNO치위19.0×10-9(13.5×10-9～49.0×10-9),음성조적FeNO치위16.0×10-9(12.0×10-9～24.0×10-9),량조간차이유통계학의의(P=0.000);유ROC곡선,득출FeNO예측지기관격발시험결과양성적계치점(cut off point)위38.5×10-9,기검험민감성위36.4％,특이성위92.6％.FeNO치여FEV1하강20％시흡입적을선갑담감루적계량(PD20-FEV1)지간불존재제량상관성.결론 FeNO수평대지기관격발시험결과유일정적예측작용.당FeNO수평＞38.5 ×10-9시가이예측지기관격발시험결과위양성적준학성교고,제시환인존재기도고반응성.
Objective To evaluate the clinical value of fractional exhaled nitric oxide (FeNO) level in asthmatic children to predict bronchial hyperresponsiveness by analyzing the correlation between fraction of exhaled nitric oxide and bronchial provocation test.Methods One hundred and fourteen asthma outpatients of Shengjing Hospital were enrolled, FeNO levels, spirometry and bronchial provocation test were measured.Results In the bronchial provocation test,there were 33 positive and 81 negative cases.The positive group had a significantly higher FeNO levels than the negative ones(19.0 × 10-9 vs.16.0 × 10-9 ,p =0.000).By the ROC curve, the best FeNO cut-off value to predict bronchial hyperresponsiveness was 38.5 × 10-9 with high specificity (92.6％) but relatively low sensitivity (36.4％).There was no relationship between methacholine provocative dose causing a 20％ fall in FEV1 (PD20-FEV1) and the level of FeNO.Conclusion FeNO level has important predicting value for bronchial hyperreactivity in children with asthma.The level of FeNO ＞ 38.5 × 10-9 has high predictive value in asthmatic children with bronchial hyperreactivity.
