本文選題：支氣管哮喘　切入點(diǎn)：呼出氣一氧化氮　出處：《石河子大學(xué)》2017年碩士論文

【摘要】：目的評價呼出氣一氧化氮(Fractional exhaled nitric oxide,Fe NO)和外周血嗜酸性粒細(xì)胞百分比(Peripheral blood eosinophilia percentage,EOS%)對支氣管哮喘診斷和病情評估的臨床應(yīng)用價值,并取得各自的最佳閾值。方法收集2015年12月至2016年6月因反復(fù)咳嗽、喘息、胸悶、氣促等癥狀就診新疆石河子大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院呼吸內(nèi)科的患者222例,所有患者均行Fe NO測定、外周血檢測及肺功能檢查,139例患者確診為哮喘,為哮喘組,均進(jìn)行哮喘病情測試(asthma control test,ACT),83例患者為非哮喘患者,為非哮喘組,統(tǒng)計并分析相關(guān)數(shù)據(jù)。結(jié)果1.哮喘組和非哮喘組一般資料情況進(jìn)行比較顯示:哮喘組年齡18~70(43.8±1.1)歲,其中男性59例,占42.4%,女性80例,占57.6%;非哮喘組年齡18~70(46.8±1.5)歲,男性25例,占30.1%,女性58例,占69.9%。兩組在性別(男/女)、平均年齡(歲)、身高(cm)、體重(kg)及BMI(kg/m2)方面比較,差異無統(tǒng)計學(xué)意義(P0.05)。2.(1)哮喘組Fe NO測定值(59.27±3.08ppb)明顯高于非哮喘組(19.65±2.13ppb)(P0.05)。哮喘組第一秒用力呼氣容積占預(yù)計值百分比(percentage of forced expiratory volumein in first second,FEVl%)(75.20±1.59%)低于非哮喘組(92.59±1.34%)(P0.05)。哮喘組EOS%(6.583±0.432%)高于非哮喘組(2.282±0.192%)(P0.05)。(2)哮喘組Fe NO與FEV1%無相關(guān)性(r=-0.037,P=0.665),與外周血EOS%存在正相關(guān)(r=0.522,P0.05)。(3)哮喘組Fe NO與ACT評分呈負(fù)相關(guān)關(guān)系(r=-0.418,P0.05),哮喘組EOS%與ACT評分呈負(fù)相關(guān)關(guān)系(r=-0.396,P0.05)。3.哮喘組Fe NO診斷哮喘的受試者工作特征(ROC)曲線下面積0.896,95%置信區(qū)間(0.853-0.940),其最佳閾值點(diǎn)為29.5ppb,以29.5ppb為界值診斷哮喘的敏感度78.4%,特異度91.6%。外周血EOS%輔助診斷支氣管哮喘的ROC曲線下面積為0.783,95%置信區(qū)間(0.722-0.844),以3.72%為最佳臨界點(diǎn),其對應(yīng)的敏感度為70.5%,特異度為86.7%。結(jié)論FeNO和外周血EOS%是輔助診斷哮喘的重要指標(biāo),兩者聯(lián)合對哮喘診斷及病情評估具有更重要的臨床意義。Fe NO和外周血EOS值越高,哮喘患者病情嚴(yán)重程度可能性更大。
[Abstract]:Objective to evaluate the clinical application of Fractional exhaled nitric oxide-iron (no) and peripheral blood eosinophilia percentage of eosinophil (EOS) in the diagnosis and evaluation of bronchial asthma, and to obtain their optimal thresholds.Methods from December 2015 to June 2016, 222 patients with recurrent cough, wheezing, chest tightness, shortness of breath and other symptoms were collected from the Department of Respiratory Medicine, the first affiliated Hospital of the Medical College of Shihezi University of Xinjiang.The peripheral blood test and pulmonary function test showed that there were 139 cases of asthma diagnosed as asthma. All the 83 cases of asthmatic control test were non-asthmatic and non-asthmatic. The related data were statistically analyzed.Result 1.The general data of asthmatic group and non-asthmatic group were compared. The age of asthmatic group was 1870,43.8 鹵1.1 years old, male 59 cases (42.4%), female 80 cases (57.6%), non-asthmatic group (1870,46.8 鹵1.5) years old, male 25 cases (30.1%), female 58 cases (69.9%).The percentage of forced expiratory volume in the first second in the asthmatic group (75.20 鹵1.59) was lower than that in the non-asthmatic group (92.59 鹵1.34).The area under the curve of 0.896 ~ 95% confidence interval was 0.853-0.940, and the optimum threshold point was 29.5ppb.The sensitivity of 29.5ppb was 78.4 and the specificity was 91.6.The area under the ROC curve of peripheral blood EOS% adjuvant diagnosis of bronchial asthma was 0.722-0.844% confidence interval, with 3.72% as the best critical point, the sensitivity was 70.5 and the specificity was 86.7%.Conclusion FeNO and EOS% in peripheral blood are important indexes in the diagnosis of asthma. The higher the value of FeNO and EOS in peripheral blood, the more likely the severity of asthma is.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R562.25

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