慢性咳嗽儿童咳嗽变异性哮喘的呼出气一氧化氮分数值
Values of fractional exhaled nitric oxide for cough-variant asthma in children with chronic cough.
作者信息
Zhou Jing, Zhao Xianhong, Zhang Xu, Yu Xingmei, Wang Yuqing, Jiang Wujun, Huang Li, Hao Chuangli, Zhang Luo
机构信息
Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou 215003, China.
Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100000, China.
出版信息
J Thorac Dis. 2018 Dec;10(12):6616-6623. doi: 10.21037/jtd.2018.11.137.
BACKGROUND
Chronic cough is a common symptom in children. We wished to explore the value of fractional exhaled nitric oxide (FeNO) for cough-variant asthma (CVA) in children with chronic cough.
METHODS
This prospective cohort study was conducted in the Children's Hospital of Soochow University from January 2012 to December 2014. Children aged 6-14 years with a cough of duration >4 weeks were enrolled. They underwent FeNO measurement, sputum cytology and pulmonary function tests.
RESULTS
A total of 115 patients and 25 healthy controls were evaluated. For the diagnosis of CVA, the optimal FeNO cutoff value was 25 ppb with a sensitivity of 84.0%, specificity of 97.1%, positive predictive value of 97.5%, and negative predictive of being 81.4%. The FeNO level had a significant correlation with eosinophil count in sputum (P<0.05). FeNO level in CVA was decreased significantly after treatment (P=0.001).
CONCLUSIONS
In children, FeNO measurement might be an excellent method for diagnosing CVA with high sensitivity and specificity.
背景
慢性咳嗽是儿童常见症状。我们希望探讨呼出气一氧化氮分数（FeNO）对慢性咳嗽儿童咳嗽变异性哮喘（CVA）的诊断价值。
方法
本前瞻性队列研究于2012年1月至2014年12月在苏州大学附属儿童医院进行。纳入6 - 14岁咳嗽持续时间>4周的儿童。他们接受了FeNO检测、痰细胞学检查和肺功能测试。
结果
共评估了115例患者和25例健康对照。对于CVA的诊断，FeNO的最佳截断值为25 ppb，敏感性为84.0%，特异性为97.1%，阳性预测值为97.5%，阴性预测值为81.4%。FeNO水平与痰中嗜酸性粒细胞计数显著相关（P<0.05）。治疗后CVA患者的FeNO水平显著降低（P = 0.001）。
结论
在儿童中，检测FeNO可能是诊断CVA的一种敏感性和特异性均较高的优秀方法。
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