Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.
Department of Family Medicine, Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
Can Respir J. 2020 Apr 25;2020:5735128. doi: 10.1155/2020/5735128. eCollection 2020.
FeNO has been used as a marker for Th2-mediated airway inflammation in asthma. There is evidence which recommends the use of this biomarker in asthma management. Little is known about whether the FeNO test alone or in combination with the ACT score can reflect asthma control in Vietnamese patients.
A cross-sectional study was conducted in asthmatic patients (≥18 years old) recruited at the University Medical Center, Ho Chi Minh City, Vietnam from March 2016 to March 2017. Asthma control levels were assessed following the GINA 2017 guidelines, and FeNO was measured by a Niox Mino device. FeNO cut-offs predicting asthma control status were determined using the ROC curve analysis. The combination of FeNO and ACT was investigated in detecting well-controlled and uncontrolled asthma. The results of the study are as follows: 278 patients with 68% females, mean age of 44 years, and mean asthma duration of 10 years were analyzed. All patients were treated following step 2 to 4 of GINA guidelines. Mean (SD) FeNO was 30.6 (24) ppb. Patients with uncontrolled (16%), partly controlled (29%), and well-controlled asthma (55%) had a median (IQR) FeNO of 50.0 (74), 25.0 (23), and 21.0 (22.3) ppb, respectively, and the mean of FeNO in the uncontrolled group was significantly higher than that in other groups ( < 0.001). The area under the ROC curve (AUC) for FeNO detecting uncontrolled asthma was 0.730 with an optimal cut-off point of FeNO > 50 ppb, and this AUC increased to 0.89 when combining FeNO and ACT. The AUC for FeNO detecting well-controlled asthma was 0.601 with an optimal cut-off point of FeNO <25 ppb and this AUC increased to 0.78 if combining FeNO and ACT.
FeNO can predict asthma control status with an estimated cut-off point of <25 ppb for well-controlled and >50 ppb for uncontrolled asthma. The combination of FeNO and ACT provides better information regarding asthma control than FeNO alone, and this combination is useful to predict asthma control statuses in asthmatic patients in Viet Nam.
FeNO 已被用作哮喘中 Th2 介导的气道炎症的标志物。有证据表明，在哮喘管理中使用这种生物标志物是有益的。目前尚不清楚单独使用 FeNO 测试或结合 ACT 评分是否可以反映越南患者的哮喘控制情况。
本横断面研究于 2016 年 3 月至 2017 年 3 月在越南胡志明市医疗中心招募的哮喘患者（≥18 岁）中进行。哮喘控制水平根据 GINA 2017 指南进行评估，使用 Niox Mino 设备测量 FeNO。使用 ROC 曲线分析确定预测哮喘控制状态的 FeNO 截止值。研究还探讨了 FeNO 和 ACT 的联合应用在检测哮喘控制良好和控制不佳患者中的作用。本研究的结果如下：共分析了 278 名女性占 68%、平均年龄 44 岁、平均哮喘病程 10 年的患者。所有患者均根据 GINA 指南的 2 至 4 步进行治疗。平均（SD）FeNO 为 30.6（24）ppb。控制不佳（16%）、部分控制（29%）和控制良好（55%）的患者的中位（IQR）FeNO 分别为 50.0（74）、25.0（23）和 21.0（22.3）ppb，控制不佳组的 FeNO 均值显著高于其他组（<0.001）。FeNO 检测控制不佳哮喘的 ROC 曲线下面积（AUC）为 0.730，最佳 FeNO 截断值为>50 ppb，当将 FeNO 与 ACT 结合时，AUC 增加至 0.89。FeNO 检测控制良好哮喘的 AUC 为 0.601，最佳 FeNO 截断值为<25 ppb，当将 FeNO 与 ACT 结合时，AUC 增加至 0.78。
FeNO 可以预测哮喘控制状态，估计控制良好的 FeNO 截断值<25 ppb，控制不佳的 FeNO 截断值>50 ppb。FeNO 与 ACT 的联合应用比单独使用 FeNO 能提供更好的哮喘控制信息，这种联合应用有助于预测越南哮喘患者的哮喘控制状态。
