采用新便携式设备检测呼出气一氧化氮：与标准技术的对比
2011/01/27
摘要
背景：呼出气一氧化氮（FeNO）是检测气道炎症的一项可靠的、无创性标志物。采用便携式FeNO分析仪，有助于在基层医疗单位进行气道炎症评价。
目的：在一项大规模的针对哮喘患者的队列研究中，比较由新型便携式设备（NObreath, Bedfont英国）检测的FeNO值与标准固定分析仪（NIOX, Aerocrine瑞典）检测值。
方法：共有168名患者入选本研究，其中154名患者完成本研究，患者年龄14～83岁，第一秒用力呼气体积（FEV1）为48～134％的预测值，哮喘控制测试（ACT）值为7～25。每名患者至少采用每个仪器，在50 ml/s恒定流速时进行2次有效的FeNO检测。
结果：两个设备检测的FeNO值具有显著相关性（r =0.95, P<0.001）。NIOX与NObreath的组内相关系数分别为0.925和0.967。通过受试者操作特征曲线分析，能鉴别ACT值≥20的患者的FeNO截止值，NIOX设备为15 ppb（敏感性0.84，特异性0.42），NObreath设备为25 ppb（敏感性0.53，特异性0.69）。通过视觉模拟评分对两种设备的使用方便性进行评价，显示未见显著差异。
结论：采用新的便携式FeNO分析仪获得的FeNO数值可靠，与固定式标准设备的检测值相当。采用便携式设备检测有助于在基层医疗机构进行FeNO检测。
（刘国梁 审校）
J Asthma. 2010 Jul 30. [Epub ahead of print]
Measurement of Fractional Exhaled Nitric Oxide by a New Portable Device: Comparison with the Standard Technique.
Pisi R, Aiello M, Tzani P, Marangio E, Olivieri D, Chetta A.
Cardiopulmonary Dept. Respiratory Disease Unit, University Hospital, Parma, Italy.
Abstract
Background. Fractional exhaled nitric oxide (FeNO) measurement is a reliable, noninvasive marker of airway inflammation. The use of portable FeNO analyzers may enable the assessment of airway inflammation in primary care.
Objective. The authors compared FeNO values obtained by a new portable device (NObreath, Bedfont, UK) to those of the standard stationary analyzer (NIOX, Aerocrine, Sweden) in a large cohort of asthmatic patients.
Methods. One hundred and fifty-four (age range: 14-83 years, forced expiratory volume in one second [FEV(1)] range: 48-134% predicted, asthma control test [ACT] range: 7-25) out of 168 recruited patients completed the study. Each patient performed at least two valid FeNO measurements at a constant flow rate of 50 ml/s on each of the two analyzers.
Results. A significant relationship between the FeNO values obtained by the two devices (r = .95, p < .001) was found. Altman-Bland plot confirmed this agreement. Within-patient repeatability was excellent in both devices. Intraclass correlation coefficients for NIOX and NObreath values were .925 and .967, respectively. By means of receiver operating characteristic curve analysis, the FeNO cutoff points that better identified patients with ACT >/= 20 were 15 ppb (0.84 sensitivity and 0.42 specificity) by NIOX and 25 ppb (0.53 sensitivity and 0.69 specificity) by NObreath. Easiness to use of both devices, assessed by visual analogue scale was not different.
Conclusion. FeNO measurements obtained by the new portable FeNO analyzer are reliable because they are directly comparable with those obtained by the stationary standard device. The use of portable instruments may facilitate the FeNO measurement in primary care.
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