College of Traditional Chinese Medicine, Hainan Medical University, Haikou, 571199, China.
The Third People's Hospital of Yancheng, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, 224001, Jiangsu Province, People's Republic of China.
Clin Rev Allergy Immunol. 2019 Apr;56(2):129-138. doi: 10.1007/s12016-016-8573-4.
The gold standard for diagnosing asthma in children is based on clinical history of respiratory symptoms, physical examination, and respiratory function testing. Recent advances indicate that a non-invasive measure of airway inflammation, fractional exhaled nitric oxide (FeNO), provides objective data for use in asthma diagnosis. However, the diagnostic performance of FeNO in children with asthma has not been clearly defined. This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of FeNO in the clinical determination of asthma in children. Databases of PubMed, the Cochrane Library, EMBASE, MEDION, and Web of Science were searched for relevant articles through March 31, 2016. A bivariate model was used for pooling estimates of sensitivity, specificity, diagnostic odds ratio (DOR), and area under the summary receiver operating curves (SROC) as the main diagnostic measures. In total, eight studies met the inclusion criteria, which included 2933 subjects. The pooled estimates of sensitivity, specificity, and DOR for the detection of asthma in children were 0.79 [95 % confidence interval (CI), 0.64-0.89], 0.81 (95 % CI, 0.66-0.90), and 16.52 (95 % CI, 7.64-35.71). The SROC was 0.87 (95 % CI, 0.84-0.90). In brief, FeNO achieves a moderate diagnostic performance in the detection of asthma in children.
儿童哮喘诊断的金标准基于临床呼吸症状史、体格检查和呼吸功能测试。最近的进展表明，气道炎症的无创测量——呼出气一氧化氮分数（FeNO）——为哮喘诊断提供了客观数据。然而，FeNO 在哮喘儿童中的诊断性能尚未明确界定。本系统评价和荟萃分析旨在评估 FeNO 在儿童哮喘临床诊断中的准确性。通过 2016 年 3 月 31 日对 PubMed、Cochrane 图书馆、EMBASE、MEDLINE 和 Web of Science 数据库进行检索，寻找相关文章。使用双变量模型对汇总敏感性、特异性、诊断比值比（DOR）和汇总受试者工作特征曲线下面积（SROC）作为主要诊断指标进行评估。共有 8 项研究符合纳入标准，包括 2933 名受试者。儿童哮喘检测的汇总敏感性、特异性和 DOR 的估计值分别为 0.79（95%CI，0.64-0.89）、0.81（95%CI，0.66-0.90）和 16.52（95%CI，7.64-35.71）。SROC 为 0.87（95%CI，0.84-0.90）。总之，FeNO 在检测儿童哮喘方面具有中等的诊断性能。
