IgE、呼出一氧化氮分数及外周血嗜酸性粒细胞在成人支气管哮喘中的诊断价值及其与疾病严重程度的关系。
Diagnostic value of IgE, fractional of exhaled nitric oxide, and peripheral blood eosinophils in adult bronchial asthma and their relationship with disease severity.
作者信息
Fang Liping, Shen Yan, Huang Tao, Wu Meiman, Duan Xinglong
机构信息
Department of Respiratory and Critical Care Medicine, Xi'an People's Hospital (Xi'an Fourth Hospital) Xi'an 710100, Shaanxi, China.
Department of Respiratory Medicine, Hanzhong People's Hospital Hanzhong 723000, Shaanxi, China.
出版信息
Am J Transl Res. 2024 Dec 15;16(12):7521-7529. doi: 10.62347/ISDG3545. eCollection 2024.
OBJECTIVE
To investigate the diagnostic value of immunoglobulin E (IgE), fractional of exhaled nitric oxide (FeNO), and peripheral blood eosinophils (EOS) in adult bronchial asthma and to analyze their relationship with asthma severity.
METHODS
A retrospective analysis was conducted on 336 patients diagnosed with bronchial asthma and admitted to Xi'an Fourth Hospital from January 2022 to January 2024, forming the asthma group. Additionally, another 127 healthy subjects were selected as the non-asthmatic control group. The patients in the asthma group were categorized into a mild asthma group (n=138), a moderate asthma group (n=115), and a severe asthma group (n=83) according to the severity of the disease. Clinical data, lung function indices, and IgE, FeNO, and EOS levels were compared across groups. ROC curves were used to assess the diagnostic value of IgE, FeNO, and EOS levels for bronchial asthma. Spearman's rank correlation analysis was used to analyze the correlation between IgE, FeNO, EOS and other indicators and asthma severity.
RESULTS
The levels of IgE, FeNO, and EOS were significantly higher in the asthma group than those in the non-asthma group, while lung function indices, peak expiratory flow rate (PEF) and forced expiratory volume in 1 s (FEV1), were significantly lower (all P < 0.05). The areas under curve (AUCs) of IgE, FeNO, and EOS for the diagnosis of asthma were 0.79, 0.93, and 0.88, respectively. Significant differences were observed in smoking history, family history of asthma, co-existing allergic rhinitis, and combined atopic eczema across different severity groups (all P < 0.05). Spearman's rank correlation analysis showed that IgE, FeNO, and EOS were positively correlated with asthma severity (all P < 0.05), with values of 0.718, 0.679, and 0.540, respectively.
CONCLUSION
IgE, FeNO, and EOS are valuable in diagnosing bronchial asthma in adults. Higher levels of IgE, FeNO, and EOS correspond to increased asthma severity, making these biomarkers useful for assessing asthma severity.
目的
探讨免疫球蛋白E（IgE）、呼出气一氧化氮分数（FeNO）及外周血嗜酸性粒细胞（EOS）在成人支气管哮喘中的诊断价值，并分析它们与哮喘严重程度的关系。
方法
对2022年1月至2024年1月在西安市第四医院确诊并收治的336例支气管哮喘患者进行回顾性分析，组成哮喘组。另外，选取127例健康受试者作为非哮喘对照组。根据疾病严重程度，将哮喘组患者分为轻度哮喘组（n = 138）、中度哮喘组（n = 115）和重度哮喘组（n = 83）。比较各组的临床资料、肺功能指标以及IgE、FeNO和EOS水平。采用ROC曲线评估IgE、FeNO和EOS水平对支气管哮喘的诊断价值。采用Spearman等级相关分析来分析IgE、FeNO、EOS与其他指标和哮喘严重程度之间的相关性。
结果
哮喘组的IgE、FeNO和EOS水平显著高于非哮喘组，而肺功能指标，如呼气峰值流速（PEF）和第1秒用力呼气容积（FEV1）则显著低于非哮喘组（均P < 0.05）。IgE、FeNO和EOS诊断哮喘的曲线下面积（AUC）分别为0.79、0.93和0.88。不同严重程度组在吸烟史、哮喘家族史、合并过敏性鼻炎以及合并特应性皮炎方面存在显著差异（均P < 0.05）。Spearman等级相关分析表明，IgE、FeNO和EOS与哮喘严重程度呈正相关（均P < 0.05），相关系数分别为0.718、0.679和0.540。
结论
IgE、FeNO和EOS在成人支气管哮喘的诊断中具有重要价值。IgE、FeNO和EOS水平越高，哮喘严重程度越高，这些生物标志物有助于评估哮喘严重程度。
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