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-  2018 

呼出气一氧化氮检测在慢性咳嗽病因诊断中的临床意义 Clinical Significance of Fractional Exhaled Nitric Oxide in the Diagnosis of Chronic Cough

Keywords: 慢性咳嗽,呼出气一氧化氮,咳嗽变异性哮喘

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Abstract:

目的:探讨呼出气一氧化氮(FeNO)检测在慢性咳嗽病因诊断中的临床意义。方法:选取我院2015年8月至2017年8月明确诊断的慢性咳嗽病例90例,其中咳嗽变异性哮喘(CVA)38例,嗜酸粒细胞性支气管炎(EB)27例,上呼吸道咳嗽综合征(UACS)15例,胃食管反流性咳嗽(GERC)10例;通过对所有患者进行诱导痰细胞学计数、FeNO检测,血清IgE检测,以分析FeNO检测在慢性咳嗽病因诊断中的临床价值,并分析FeNO水平与诱导痰嗜酸粒细胞比例、血清IgE的相关性;通过受试者工作特征曲线分析出CVA及EB的诊断阈值。结果:检测患者中CVA组FeNO值为(52.2±12.7)ppb(1ppb=1×10-9 mol/L),高于EB组(35.7±14.2)ppb(P<0.01),并显著高于UACS组(19.0±3.7)ppb及GERC(18.6±3.5)ppb(P<0.01),CVA组中FeNO值与痰诱导嗜酸粒细胞比例显著正相关,与血清IgE有相关性;通过受试者工作特征曲线分析诊断CVA的FeNO最佳阈值为40.5ppb,所对应的灵敏度为84.2%,特异度为76.9%;诊断EB的FeNO最佳阈值27.5ppb,所对应的灵敏度为85.2%,特异度为84%。结论:FeNO水平在慢性咳嗽不同病因患者中有明显差异,FeNO检测对CVA及EB的诊断有较高的特异度和灵敏度

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