支气管哮喘急性发作期患者呼出气一氧化氮的诊断价值及与肺功能和血清ECP、IL-13的关系研究

摘要 目的：研究支气管哮喘（BA）急性发作期患者呼出气一氧化氮（FeNO）的诊断价值及与其肺功能和血清嗜酸性粒细胞阳离子蛋白（ECP）、白细胞介素-13（IL-13）的关系。方法：将我院从2018年1月～2020年1月收治的78例BA患者纳入研究，将其按照病情的不同分成急性发作组（急性发作期）42例与非急性发作组（缓解期）36例。比较两组FeNO、肺功能指标水平和血清ECP、IL-13水平，并作相关性分析。此外，以受试者工作特征（ROC）曲线分析FeNO对BA急性发作期的有关诊断效能。结果：急性发作组FeNO水平高于非急性发作组，而最大呼气流量占预计值的百分比（PEF%pred）、第1秒用力呼气末容积占预计值的百分比（FEV₁%pred）及用力肺活量占预计值的百分比（FVC%pred）水平均低于非急性发作组（均P＜0.05）。急性发作组血清ECP、IL-13水平均高于非急性发作组（均P＜0.05）。经Pearson相关分析发现：BA急性发作期患者FeNO与PEF%pred、FEV₁%pred、FVC%pred均呈负相关，而与血清ECP、IL-13水平均呈正相关（均P＜0.05）。经ROC曲线分析发现：FeNO诊断BA急性发作期的曲线下面积为0.818，敏感度与特异度分别为75.51%、94.05%。结论：BA急性发作期患者FeNO水平显著升高，且和肺功能、血清ECP、IL-13密切相关，检测FeNO对BA急性发作期患者具有较高的诊断价值。

The Diagnostic Value of Exhaled Nitric Oxide in Patients with Acute Attack of Bronchial Asthma and Its Relationship with Lung Function and Serum ECP and IL-13

ABSTRACT Objective: To study the diagnostic value of exhaled nitric oxide (FeNO) and its relationship with lung function, serum eosinophil cationic protein (ECP) and interleukin-13 (IL-13) in patients with bronchial asthma(BA) acute attack period. Methods: A total of 78 patients with BA admitted to our hospital from January 2018 to January 2020 were included in the study, and they were divided into 42 patients in the acute attack group (acute attack period) and 36 patients in the non-acute attack group (remission) according to their different conditions. The levels of FeNO, lung function indexes, serum ECP and IL-13 in the two groups were compared, and the correlation was analyzed. In addition, diagnostic efficacy of FeNO in BA acute attack period was analyzed by receiver operating characteristic (ROC) curve. Results: The level of FeNO in the acute attack group was higher than that in the non-acute attack group, while the levels of percentage of peak expiratory flow in the predicted value (PEF%pred), percentage of forced expiratory volume of the first second in the predicted value (FEV₁%pred) and percentage of forced vital capacity in the predicted value (FVC%pred) were lower than that in the non-acute attack group (all P < 0.05). The serum levels of ECP and IL-13 in the acute attack group were higher than those in the non-acute attack group (all P < 0.05). Pearson correlation analysis found that, FeNO was negatively correlated with PEF%pred, FEV₁%pred and FVC%pred in patients with BA acute attack period, while positively correlated with serum ECP and IL-13 levels (all P < 0.05). ROC curve analysis showed that the area under the curve in FeNO diagnosis of BA acute attack period was 0.818, sensitivity and specificity were 75.51% and 94.05% respectively. Conclusion: The level of FeNO is significantly increased in patients with BA acute attack period, which is closely related to lung function, serum ECP and IL-13, detection of FeNO has high diagnostic value for BA acute attack period patients.