呼出一氧化氮在支气管扩张症伴支气管哮喘诊断中的重要性
2016/07/28
摘要
背景：测量呼出一氧化氮（FeNO）是一种简单、快速、重复性好、无创伤的对气道炎症评估一种方法。因此，呼出一氧化氮（FeNO）广泛用于哮喘的诊断和管理。用呼出一氧化氮（FeNO）作为替代常规肺功能试验来鉴别支气管扩张症(BE)合并支气管哮喘和单独的支气管扩张症病人的可行性还不清楚。
方法：从2013年2月到2016年2月，99例通过高分辨率CT（HRCT）进行诊断为支气管扩张(BE)接受FeNO测定、支气管激发试验（BCT），或支气管扩张试验。气道高反应性和/或可逆性气道阻塞被用来定义哮喘。获得接受者操作特征（ROC）曲线来阐明FeNO在支气管扩张哮喘患者诊断的临床功能，并确定最佳工作点。
结果：99例支气管扩张患者中，20例表现为哮喘，其中12例患者接受正规治疗，分别给予布地奈德（200 µg, bid）治疗12周，观察FeNO值的变化并评估FeNO在治疗中的作用。FeNO 在ROC曲线下的面积估计为0.832。结果还显示，截断值> 22.5 part per billion (ppb) 的FeNO可以鉴别有支气管扩张的哮喘和非哮喘（敏感性，90%；特异性，62.5%）患者。治疗后，FeNO和1秒用力呼气量明显改善。
结论：临床FeNO测定是从支气管扩张患者中鉴别出合并哮喘的一种简单、无创、快速的方法。这种技术在哮喘管理中有应用前景。
（杨冬 审校）
J Thorac Dis. 2016 May;8(5):992-9. doi: 10.21037/jtd.2016.03.72.
Importance of fractional exhaled nitric oxide in diagnosis of bronchiectasis accompanied with bronchialasthma.
Chen FJ1, Liao H1, Huang XY1, Xie CM1.
Author information
Abstract
BACKGROUND:Fractional exhaled nitric oxide (FeNO) measurement is a simple, rapid, highly reproducible, and noninvasive method of airway inflammation assessment. Therefore, FeNO is extensively used for the diagnosis and management of asthma. The feasibility of using FeNO as an alternative to conventional pulmonary function test to differentiate patients with bronchiectasis (BE) and bronchial asthma from those with BE only remains unclear.
METHODS:From February 2013 to February 2015, 99 patients diagnosed with BE through high-resolution computed tomography (HRCT) were subjected to FeNO measurement, bronchial challenge test (BCT), or bronchodilator test. Bronchial hyperreactivity and/or reversible airway obstruction was used to define asthma. The receiver operating characteristic (ROC) curves were obtained to elucidate the clinical functions of FeNO in the diagnosis of asthmatic patients with BE, and the optimal operating point was also determined.
RESULTS:Of 99 patients with BE, 20 patients presented asthma, and 12 of these patients received regular treatment, which were given with budesonide (200 µg, bid) for 12 weeks to evaluate changes in the concentration and assess the role of FeNO in the treatment. The area under the ROC curve was estimated as 0.832 for FeNO. Results also revealed a cut off value of >22.5 part per billion (ppb) FeNO for differentiating asthmatic from non-asthmatic (sensitivity, 90.0%; specificity, 62.5%) patients with BE. FeNO and forced expiratory volume for 1 second significantly improved after the treatment.
CONCLUSIONS:Clinical FeNO measurement is a simple, noninvasive, and rapid method used to differentiate asthmatic from nonasthmatic patients with BE. This technique exhibits potential for asthma management.
KEYWORDS:Fractional exhaled nitric oxide (FeNO); asthma; asthma management; bronchiectasis (BE)
J Thorac Dis. 2016 May;8(5):992-9. doi: 10.21037/jtd.2016.03.72.
上一篇：
儿童特应性皮炎的可靠评估的介绍：新的儿童特应性皮炎诊断标准
下一篇：
哮喘患者过敏原刺激后气道树突状细胞的IL-25受体表达
