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[鼻一氧化氮在原发性纤毛运动障碍诊断中的价值]

[Value of nasal nitric oxide in the diagnosis of primary ciliary dyskinesia].

作者信息

Moreno Galdó A, Vizmanos Lamotte G, Reverte Bover C, Gartner S, Cobos Barroso N, Rovira Amigo S, Liñán Cortés S, Lloreta Trull J, Busquets Monge R

机构信息

Hospital Universitari Vall d'Hebron, Barcelona, España.

出版信息

An Pediatr (Barc). 2010 Aug;73(2):88-93. doi: 10.1016/j.anpedi.2009.10.026. Epub 2010 Mar 23.

Abstract

OBJECTIVE

The aim of this study is to report nasal nitric oxide (nNO) values in children with primary ciliary dyskinesia (PCD) and to compare them with nNO values in healthy children, asthmatic children, children with cystic fibrosis and children with post infectious bronchiectasis.

PATIENTS AND METHODS

We determined nNO values in 9 children with PCD, 36 asthmatic children, 31 children with cystic fibrosis, 8 children with post infectious bronchiectasis and 37 healthy children. We compared nNO values between these different conditions and calculated sensitivity and specificity of nNO to diagnose PCD.

RESULTS

All children with PCD - except one (nNO 348 ppb) - had nNO values below 112 ppb, mean 88 ppb (95%CI 9.6-166). The nNO mean was 898 ppb (95%CI 801-995) in healthy children, 1023 ppb (95%CI 911-1137) in asthmatic children, 438 ppb (95%CI 367-508) in cystic fibrosis children and 361 ppb (95%CI 252-470) in children with post infectious bronchiectasis. The mean concentration of nNO was lower (P<0.05) in PCD patients, compared to the other groups. The measurement of nasal NO in our study population showed, at a cut-off level of < or =112 ppb, a sensitivity of 88.9% and a specificity of 99.1% in the diagnosis of PCD [ROC 0.98 (95%CI 0.94-0.99); P<0.0001; probability ratio 95.1].

CONCLUSIONS

The measurement of nasal NO appears to be a useful tool for screening children for PCD, in which a cut-off level of < or =112 ppb suggests the disease, although nNO above 112 ppb does not exclude PCD.

摘要

目的

本研究旨在报告原发性纤毛运动障碍(PCD)患儿的鼻一氧化氮(nNO)值,并将其与健康儿童、哮喘儿童、囊性纤维化患儿及感染后支气管扩张患儿的nNO值进行比较。

患者与方法

我们测定了9例PCD患儿、36例哮喘患儿、31例囊性纤维化患儿、8例感染后支气管扩张患儿及37例健康儿童的nNO值。我们比较了这些不同情况下的nNO值,并计算了nNO诊断PCD的敏感性和特异性。

结果

除1例(nNO 348 ppb)外,所有PCD患儿的nNO值均低于112 ppb,平均为88 ppb(95%CI 9.6 - 166)。健康儿童的nNO平均值为898 ppb(95%CI 801 - 995),哮喘儿童为1023 ppb(95%CI 911 - 1137),囊性纤维化患儿为438 ppb(95%CI 367 - 508),感染后支气管扩张患儿为361 ppb(95%CI 252 - 470)。与其他组相比,PCD患者nNO的平均浓度较低(P<0.05)。在我们的研究人群中,测量鼻一氧化氮时,在截断水平≤112 ppb时,诊断PCD的敏感性为88.9%,特异性为99.1%[ROC 0.98(95%CI 0.94 - 0.99);P<0.0001;概率比95.1]。

结论

鼻一氧化氮测量似乎是筛查儿童PCD的有用工具,截断水平≤112 ppb提示患有该疾病,但nNO高于112 ppb不能排除PCD。

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