| BackgroundIn the last few years,more and more people suffer from asthma,and people have found that asthma is a heterogeneous disease.Pulmonary function tests can help diagnose asthma.However,in some children with normal pulmonary function,airway inflammation is still present.To reflect the inflammatory properties,a study on fraction of exhaled nitric oxide(FeNO)was developed.The combination of FeNO and blood eosinophilia(EOS)reflects airway eosinophilic inflammation,but there are still different opinions on the correlation between exhaled nitric oxide and pulmonary function indicators,so it is necessary to carry out relevant studies.ObjectionIn this study,the FeNO value was compared between children with asthma aged 6-14years and healthy children,ROC curve was drawn,and the threshold value of FeNO for asthma evaluation was analyzed.Besides,by comparing FeNO,the number of eosinophilia,lung function with asthma and healthy children to analyze the correlation between FeNO and blood eosinophils and lung function,so as to rich clinical experience and to provide reference for clinical diagnosis and treatment.MethodsFrom May 2019 to May 2021,98 children aged 6-14 years with asthma in Puyang People’s Hospital were selected as asthma group,which were divided into acute exacerbation,chronic persistent and clinical remission,the number of cases in each stage was 37,32 and 29 respectively,and healthy children control group.After the informed consent of family members,FeNO,EOS,lung function,Ig E and other tests were completed for children in asthma group and control group,and the data were sorted out and analyzed.Spearman rank correlation analysis was used to analyze the correlation between FeNO and EOS and lung function.At the same time,Statistical Product and Service Solutions is used to analysis the data.If the data conform to the normal distribution,we can use the average and the standard deviation express.Otherwise,we use the inter-quartile range to express.To compare non-normally distributed multiple copies,K-W H test was used.The Mann-Whitney U test was used for comparison between groups without normal distribution.Spearman rank correlation analysis was used to analyze the correlation between FeNO,EOS and FEV1.If P<0.05,it indicated that significant differences between the two groups of data.Finally,in this study,ROC curve was drawn based on FeNO results to determine the correlation between FeNO values and asthma,so as to provide reference for clinical diagnosis and treatment.Results1.(1)There was no significant difference in age and gender between asthma group and control group(P>0.05).(2)FeNO,EOS and Ig E levels in asthma group were significantly higher than those in control group,and the difference was statistically significant(P<0.01).2.(1)The FeNO values of control group,clinical remission,chronic persistent and acute exacerbation were 13(11.75,14.00)parts per billion,18(12.5,19.0)parts per billion,36(35.50,37.00)parts per billion,38(35.25,39.00)parts per billion,and EOS values were0.15(0.11,0.17)×10~9/L,0.27(0.26,0.32)×10~9/L,0.29(0.27,0.32)×10~9/L,0.53(0.51,0.55)×10~9/L.The FeNO and EOS values of three stages in asthma group were higher than those in control group,and the differences were statistically significant(P<0.01).(2)FeNO and EOS in acute exacerbation and chronic persistent of asthma were higher than those in clinical remission,and the differences were statistically significant(P<0.01).3.The values of pulmonary function parameters in the acute exacerbation were lower than those in the control group,chronic persistent and clinical remission,with significant differences(P<0.01).4.FeNO was positively correlated with serum total Ig E and blood EOS,and the correlation coefficients were 0.94 and 0.685,respectively(P<0.01).There was no correlation between FeNO and FEV1%and FEV1/FVC,P>0.05.5.FeNO and EOS of asthma group were significantly decreased after treatment,and the difference was statistically significant(P<0.01).6.The ROC area of FeNO for the clinical diagnosis of asthma was 0.885,95%confidence range was 0.816 to 0.955,and the optimal threshold of the curve was 28.5 parts per billion,with a specificity equal to 84%.Conclusion1.The value of FeNO was significantly higher in children with asthma,and the value of FeNO was related to the intensity of asthma;2.There is positively correlated between FeNO and blood eosinophils,combining the values of FeNO and EOS,we can judge patients have eosinophilic inflammation in the airway;3.When FeNO>28.5 parts per billion,it can be used as an important basis for evaluating bronchial asthma. |
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