Xia Qing, Pan Pinhua, Wang Zhan, Lu Rongli, Hu Chengping
Department of Respiration and Critical Care Medicine, Xiangya Hospital, Central South Univesity, Changsha 410008, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2014 Apr;39(4):365-70. doi: 10.3969/j.issn.1672-7347.2014.04.008.
To explore the change of fractional exhaled nitric oxide (FeNO) and its correlation with forced expiratory volume in the first second (FEV1), the first second forced expiratory volume percentage of forced vital capacity (FEV1/FVC) in bronchial asthma and chronic obstructive pulmonary disease (COPD).
FeNO, FEV1 and FEV1/FVC were measured in 57 suspected asthmatics (21 acute onsets, 12 non-acute and 24 non-asthma), 38 COPD patients (25 acute exacerbations and 13 stable stages) and 26 healthy subjects.
In the 57 suspected asthmatic patients, when the optimal cut off value of FeNO was 20.15 PPb, which was used to diagnose asthma and differentiate asthma and non-asthma, the positive predictive value, the negative predictive value, the sensitivity and the specificity was 94.1%, 95.7%, 97.0%, and 91.7% respectively. There was significant difference in the FeNO level between the 33 asthmatics and 26 healthy subjects (P<0.05). There was also significant difference in the FeNO level between the acute onset and the non-acute (P<0.05), but not in the FEV1 and FEV1/FVC level (both P>0.05). There was no significant correlation between FeNO and FEV1, FEV1/FVC in patients with asthma (r=-0.186, -0.236, both P>0.05). There was significant difference in the levels of FeNO, FEV1 and FEV1/FVC between the 38 COPD patients and the 26 healthy subjects (all P<0.05), and also between the 25 acute exacerbations and 13 stable COPDs (all P<0.05), but not between the 13 stable COPDs and 26 healthy subjects (all P>0.05). FeNO was not correlated with FEV1 and FEV1/FVC level in COPD patients (r=-0.167, -0.285, both P>0.05).
FeNO level is increased obviously in patients with asthma. The optimal cut off value of FeNO at 20.15 PPb can differentiate asthma and non-asthma with high sensitivity and specificity. FeNO is higher for the acute onset than non-acute, which may be useful to evaluate the control degree. FeNO level is increased in COPD patients in the acute exacerbations, but there is no change in stable COPD patients compared with the healthy subjects.
探讨支气管哮喘和慢性阻塞性肺疾病（COPD）患者呼出气一氧化氮分数（FeNO）的变化及其与第一秒用力呼气容积（FEV1）、第一秒用力呼气容积占用力肺活量百分比（FEV1/FVC）的相关性。
对57例疑似哮喘患者（21例急性发作、12例非急性发作和24例非哮喘患者）、38例COPD患者（25例急性加重期和13例稳定期）及26例健康受试者进行FeNO、FEV1和FEV1/FVC测定。
在57例疑似哮喘患者中，当FeNO的最佳截断值为20.15 PPb用于诊断哮喘及鉴别哮喘与非哮喘时，其阳性预测值、阴性预测值、敏感性和特异性分别为94.1%、95.7%、97.0%和91.7%。33例哮喘患者与26例健康受试者的FeNO水平差异有统计学意义（P<0.05）。急性发作与非急性发作患者的FeNO水平差异也有统计学意义（P<0.05），但FEV1和FEV1/FVC水平差异无统计学意义（均P>0.05）。哮喘患者中FeNO与FEV1、FEV1/FVC无显著相关性（r=-0.186、-0.236，均P>0.05）。38例COPD患者与26例健康受试者的FeNO、FEV1和FEV1/FVC水平差异均有统计学意义（均P<0.05），25例急性加重期与13例稳定期COPD患者的上述指标差异也有统计学意义（均P<0.05），但13例稳定期COPD患者与26例健康受试者的上述指标差异无统计学意义（均P>0.05）。COPD患者中FeNO与FEV1、FEV1/FVC水平无相关性（r=-0.167、-0.285，均P>0.05）。
哮喘患者FeNO水平明显升高。FeNO的最佳截断值为20.15 PPb时，可高灵敏度和特异性地鉴别哮喘与非哮喘。急性发作患者的FeNO高于非急性发作患者，这可能有助于评估控制程度。COPD患者急性加重期FeNO水平升高，但稳定期COPD患者与健康受试者相比无变化。
