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一项关于下呼吸道呼出的氧化与小呼吸道参数相结合的价值的比较研究,用于诊断咳变异性喘
Haodong Bai1, Cuiqin Shi1, Sue Yu1
1Department of Pulmonary and Critical Care Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
Therapeutic advances in respiratory disease
|June 16, 2023
概括
200毫升/秒的微量呼出的氧化 (FeNO200) 是诊断咳变异性喘 (CVA) 的一个有价值的非侵入性生物标志物. 升高的FeNO200水平,特别是超过11ppb,在患有小呼吸道功能障碍的患者中有效区分CVA.
科学领域:
- 肺部病理学 肺部病理学
- 过敏和免疫学 过敏和免疫学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 咳变异性喘 (CVA) 诊断依赖于具有挑战性的支气管挑测试.
- CVA通常涉及2型气道炎症和小气道功能障碍.
- 在200mL/s (FeNO200) 的微量呼出的氧化反映了小气道炎症,可能有助于CVA诊断.
研究的目的:
- 为了评估下呼吸道排气的氧化 (FeNO50,FeNO200,CaNO) 的诊断实用性和CVA的小呼吸道参数.
- 为了比较不同FeNO测量和螺旋计指数在诊断CVA时的有效性.
主要方法:
- 招募了71名CVA和212名非CVA (NCVA) 慢性咳患者.
- 估计的FeNO50,FeNO200,CaNO,MMEF,FEF75%,以及FEF50%. 它们的含量是什么?
- 使用接收器操作特征曲线分析诊断值.
主要成果:
- 在CVA组中,FeNO50,FeNO200和CaNO显著更高.
- 与FeNO50 (AUC 0.88) 相比,FeNO200显示出更高的诊断性能 (AUC 0.92),而FeNO50则显示出更高的诊断性能 (AUC 0.88).
- 将FeNO200与小气道参数 (MMEF,FEF75%,FEF50%) 结合起来,进一步提高了诊断准确度 (AUC 0.93).
结论:
- FeNO200>>11 ppb是区分CVA和慢性咳的强有力的指标.
- FeNO200在患有小呼吸道功能障碍的患者中特别有用.
- FeNO200提供了一个有价值的,非侵入性的工具,用于CVA诊断.
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