| Objective: To investigate the effect of nNO in the diagnosis and treatment in patients with middle-to-severe allergic rhinitis(AR)by detecting nasal nitric oxide(nNO)and nNO concentration before and after treatment,to explore the value of nNO in clinical auxiliary diagnosis and evaluation of curative effect in patients with AR.Methods: From January 2018 to November 2018,he was treated in the outpatient department of Otorhinolaryngology Head and Neck Surgery of Gansu Provincial Hospital.According to the symptoms,signs and related examinations,152 patients with moderate-to-severe AR and 108 patients with non-allergic rhinitis(NAR)were used as experimental group.1All subjects underwent general medical history collection,using the Sunvou Nakulon breath analyzer system for nNO concentration detection,and compared with other objective examination indicators of the experimental group to explore the correlation between them;visual analogue scale was also used(visual analogue score,VAS)on the patient's nas25 healthy subjects with no nasal discomfort were selected as the control group.al symptom score and rhinoconjunctivitis quality of life questionnaire(RQLQ),to explore the relationship between nNO concentration changes before and after treatment with nasal glucocorticoid and subjective symptoms relationship.SPSS22.0 statistical software was used for analysis.One-way analysis of variance was used for comparison among the three groups,and Pearson correlation analysis was used for correlation analysis between the data of normal distribution and measurement data.Results:1.The concentration of nNO in the AR group was(693.64±236.62)ppb,the concentration of nNO in the NAR group was(430.04±92.15)ppb,and the concentration of nNO in the control group was(400.17±102.59)ppb.The concentration of nNO in the AR group was significantly higher than that in the NAR group and the control group.Statistically significant(P<0.05);nNO concentration in the NAR group was slightly higher than the control group,but the difference was not statistically significant(P>0.05).2.The percentage of eosinophilic(EOS)and serum total IgE(tIgE)in the AR group were significantly higher than those in the NAR group and the control group(P<0.05).The AR group and the other two groups of lungs were significantly different(P<0.05).There were differences in function.The MMEF,FEF50%,and FEF75%indexes were lower than those in the NAR group and the control group,and the difference was statistically significant(P<0.05).There was no significant difference in objective indicators between the NAR group and the control group(P>0.05).3.According to Pearson correlation analysis,there was a linear relationship between nNO concentration and EOS% in AR group,and there was a low positive correlation(r=0.229,P<0.05),but there was no linear correlation with other objective indicators.4.By plotting the ROC curve of nNO concentration,the area under the curve is AUC=88.8%(P<0.05),the maximum value of the Yoden index is 0.683,and when the sensitivity is 80.3% and the specificity is 88%,the nNO of AR is diagnosed.The optimal threshold is 518 ppb.5.There was no significant difference in the concentration of nNO between seasonal AR and perennial AR(P>0.05).The difference of nNO between intermittent AR and persistent AR was statistically significant(P<0.05).6.The concentration of nNO in the experimental group decreased significantly after treatment,and the difference of nNO concentration in the AR group at different treatment points was statistically significant(P<0.05);However,the change of nNO concentration and subjective symptoms(VAS and RQLQ scores),there is no correlation between them.Conclusions:1.The concentration of nNO in medium-to-severe AR was significantly increased,and it was positively correlated with EOS%,indicating that nNO can reflect airway eosinophilic inflammation to a certain extent,and it has certain value as an objective diagnostic index of AR.The diagnostic threshold is 518 ppb.2.There may be differences in nNO concentrations in patients with different types of AR.Intermittent AR concentrations are higher than persistent AR,which maybe related to the length of nasal mucosal inflammation.3.The concentration of nNO was significantly decreased before and after treatment with nasal hormones,indicating that the change of nNO concentration after treatment was very sensitive,and the efficacy of the drug could be judged to some extent,but it had no obvious linear relationship with the improvement of subjective symptoms,so it could not be used as a predictor indicator of symptoms. |
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