Department of Internal Medicine, The Armed Forces Capital Hospital, Republic of Korea.
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Chest. 2012 May;141(5):1267-1272. doi: 10.1378/chest.11-1303. Epub 2011 Oct 20.
Acute eosinophilic pneumonia (AEP) is an idiopathic disease characterized by pulmonary eosinophilia. Because the fraction of exhaled nitric oxide (Feno) is a surrogate of eosinophilic inflammation, we evaluated the levels, changed treatments, and the diagnostic role of Feno in patients with AEP.
Between June 2010 and March 2011, we prospectively enrolled patients at the Armed Forces Capital Hospital who had pulmonary infiltrates and a febrile illness and who were clinically suspected to have AEP. We measured Feno twice at the initial visit (pretreatment) and 2 weeks after the initial measurement (posttreatment).
A total of 60 subjects were enrolled, and 31 were given a diagnosis of AEP. The pretreatment Feno levels of the patients with AEP were significantly higher than those of the patients without AEP (median, 48 parts per billion [ppb] [range, 10-138] vs 14 ppb [range, 5-41]; P < .001). The cut-off value (23.5 ppb) showed that the maximal area under the receiver operating characteristic curve predicted AEP with a sensitivity of 0.87 and a specificity of 0.83. The posttreatment Feno levels decreased significantly in the patients with AEP, and the levels were similar to the patients without AEP (median, 19 ppb [range, 7-44] vs 14 ppb [range, 1-58]; P = .21)
The Feno level was significantly higher in patients with AEP than in those without AEP. Feno measurement can be used as a diagnostic tool to differentiate patients with AEP from those without AEP.
ClinicalTrials.gov; No.: NCT01152424; URL: www.clinicaltrials.gov.
急性嗜酸性粒细胞肺炎（AEP）是一种特发性疾病，其特征为肺部嗜酸性粒细胞增多。由于呼出气一氧化氮（Feno）分数是嗜酸性粒细胞炎症的替代物，因此我们评估了 Feno 水平、改变的治疗方法以及 Feno 在 AEP 患者中的诊断作用。
在 2010 年 6 月至 2011 年 3 月期间，我们前瞻性地招募了在武装部队总医院就诊的肺部浸润和发热且临床疑似患有 AEP 的患者。我们在初始就诊时（治疗前）和初始测量后 2 周（治疗后）两次测量 Feno。
共纳入 60 例患者，其中 31 例被诊断为 AEP。AEP 患者的治疗前 Feno 水平明显高于无 AEP 患者（中位数，48 个部分每十亿（ppb）[范围，10-138]与 14 ppb [范围，5-41]；P<0.001）。最佳截断值（23.5 ppb）显示，最大受试者工作特征曲线下面积预测 AEP 的灵敏度为 0.87，特异性为 0.83。AEP 患者的治疗后 Feno 水平显著下降，且与无 AEP 患者相似（中位数，19 ppb [范围，7-44]与 14 ppb [范围，1-58]；P=0.21）。
AEP 患者的 Feno 水平明显高于无 AEP 患者。Feno 测量可作为一种诊断工具，用于区分 AEP 患者和无 AEP 患者。
ClinicalTrials.gov；编号：NCT01152424；网址：www.clinicaltrials.gov。
