运动激发试验联合FeNO检测对儿童咳嗽变异性哮喘的诊断价值OA
Diagnostic value of exercise challenge test combined with FeNO detection on children with cough variant asthma
目的 探讨运动激发试验(ECT)联合呼出气一氧化氮(FeNO)检测在儿童咳嗽变异性哮喘(CVA)中的诊断价值.方法 回顾性分析2022年6月至2024年6月北京京煤集团总医院收治的132例进行ECT的慢性咳嗽患儿的临床资料,并根据是否发生CVA将患儿分为CVA组(n=72)与非CVA组(n=60).采用肺功能测定仪检测患儿第1秒用力呼气容积(FEV1)、用力肺活量(FVC),并计算FEV1/FVC比值.记录ECT检查后FEV1 下降百分比.使用纳库伦呼气分析仪(Sunvon-CA2122 NO型)测定患儿FeNO水平.采用多因素Logistic回归分析慢性咳嗽患儿发生CVA的影响因素.绘制受试者工作特征(ROC)曲线评估相关指标对慢性咳嗽患儿发生CVA的诊断价值.结果 2组FVC、FEV1 和FEV1/FVC比值比较,差异均无统计学意义(P>0.05);CVA组FEV1 下降百分比明显高于非CVA组,差异有统计学意义(P<0.05).CVA组FeNO水平为(20.68±5.09)ppb,明显高于非CVA组的(13.56±4.17)ppb,差异有统计学意义(P<0.05).多因素Lo-gistic回归分析结果显示,FEV1 下降百分比增加、FeNO水平升高均为慢性咳嗽患儿发生CVA的独立危险因素(P<0.05).ROC曲线分析结果显示,FEV1 下降百分比、FeNO单独及联合诊断慢性咳嗽患儿发生CVA的曲线下面积(AUC)分别为0.758、0.729、0.825,二者联合诊断的AUC明显大于各指标单独诊断(P<0.05).结论 FeNO水平及ECT后FEV1 下降百分比均对慢性咳嗽患儿发生CVA有诊断价值,且二者联合应用可提高诊断效能.
Objective To explore the diagnostic value of exercise challenge test(ECT)combined with frac-tional exhaled nitric oxide(FeNO)detection on children with cough variant asthma(CVA).Methods A ret-rospective analysis was conducted on the clinical data of 132 children with chronic cough who underwent ECT in Beijing Jingmei Group General Hospital from June 2022 to June 2024.The children were divided into the CVA group(n=72)and the non-CVA group(n=60)based on whether CVA occurred.The forced expiratory volume in one second(FEV1)and forced vital capacity(FVC)were measured by pulmonary function tester,and FEV1/FVC ratio was calculated.The FEV1 decline percentage after ECT was recorded.The level of FeNO was measured by Nakuren breath analyzer(Sunvon-CA2122 NO).Multivariate Logistic regression analysis was used to analyze the influencing factors for CVA in children with chronic cough.Receiver operating charac-teristic(ROC)curve was applied to evaluate the diagnostic value of related indicators for CVA.Results Com-parisons of FVC,FEV1 and FEV1/FVC ratio between the two groups showed no statistically significant differ-ences(P>0.05).The FEV1 decline percentage was significantly higher in the CVA group than that in the non-CVA group(P<0.05).The FeNO level in the CVA group was(20.68±5.09)ppb,which was signifi-cantly higher than(13.56±4.17)ppb in the non-CVA group(P<0.05).Multivariate Logistic regression a-nalysis revealed that increased FEV1 decline percentage and elevated FeNO were independent risk factors for CVA in children with chronic cough(P<0.05).ROC curve analysis suggested that the areas under the curves(AUCs)for predicting CVA in children with chronic cough by FEV1 decline percentage,FeNO alone and in combination were 0.758,0.729 and 0.825,respectively,the AUC of the combination of the two indicators was significantly higher than that of each predictor alone(P<0.05).Conclusion Both FeNO level and FEV1 de-cline percentage after ECT have diagnostic value on CVA in children with chronic cough,and the combined ap-plication of the two indicators can enhance the diagnostic efficiency.
焦素敏;谷卉姿;王巍;刘晓灵
北京京煤集团总医院儿科,北京 102399北京京煤集团总医院儿科,北京 102399北京京煤集团总医院儿科,北京 102399北京儿童医院呼吸科,北京 100045
医药卫生
咳嗽变异性哮喘儿童运动激发试验呼出气一氧化氮第1秒用力呼气容积诊断
cough variant asthmachildrenexercise challenge testfractional exhaled nitric oxideforced expiratory volume in one seconddiagnosis
《检验医学与临床》 2026 (2)
203-208,6
北京市自然科学基金项目(7202045)北京京煤集团总医院科研自主项目(ZZ2024-50).
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