Diagnostic Value Of FeNo、CaNo And EOS In Adult Bronchial Asthma And Their Correlation With The Severity Of The Disease

Objective:To explore the diagnostic value of exhaled nitric oxide(Fe NO),alveolar nitric oxide(Ca NO),and eosinophil(EOS)in adult bronchial asthma,and analyze their relationship with the severity of asthma,so as to provide more information for the diagnosis and treatment of bronchial asthma.Methods:A total of 150 patients with suspected asthma and complete data admitted to Shanxi Bethune Hospital from January 2021 to September 2022 were retrospectively collected as research objects.According to the"Guidelines for the Prevention and Treatment of Bronchial Asthma(2020 Edition)"formulated by the Asthma Group of the Respiratory Branch of the Chinese Medical Association,94 patients diagnosed with bronchial asthma were used as the asthma group,and 56 non asthma patients were used as the control group;According to the severity grading criteria of the guidelines,94 asthma patients in the asthma group were divided into mild asthma group(27 cases),moderate asthma group(39 cases),and severe asthma group(28 cases).The relevant clinical data of the study subjects were statistically analyzed,including gender,age,height,weight,body mass index,Fe NO,Ca NO,and EOS.SPSS26.0 statistical software was used for data analysis.First,the measurement data were subjected to a normal test,and the measurement data conforming to the normal distribution were measured using the mean±standard deviation((?)±s)represents,the comparison between the two groups was conducted using t-test,and the comparison of multiple independent samples was conducted using One-Way ANOVA.The skewed data are expressed in terms of median and interquartile spacing Md(Q1,Q3).Two samples were compared using Mann Whitney U test,and multiple samples were compared using Kruskal Wallis H test.The counting data were expressed in percentage(%),and the comparison between groups was performed using chi-square test.The diagnostic value of individual and combined detection using ROC curve analysis indicators was analyzed.The relationship between clinical indicators and asthma severity was analyzed using Spearman rank correlation analysis.P<0.05 is considered statistically significant.Results:1.There was no significant difference in the general data between the asthma group and the control group(P>0.05).The levels of Fe NO,Ca NO,and EOS in the asthma group were higher than those in the control group,the difference was statistically significant(P<0.05).2.The threshold for Fe NO diagnosis of asthma was 34.45ppb,with a sensitivity of 77.7%,specificity of 82.1%,and area under ROC curve of 0.874(95%CI:0.820-0.928).The threshold for Ca NO to diagnose asthma was 6.55ppb,with a sensitivity of 73.4%,specificity of 83.9%,and area under ROC curve of 0.796(95%CI:0.725-0.866).The threshold for EOS diagnosis of asthma was 0.285×10~9/L,with a sensitivity of 61.7%,a specificity of 92.9%,and an area under the ROC curve of 0.790(95%CI:0.718-0.862).Fe NO+Ca NO+EOS had the largest area under the curve,which was 0.879(95%CI:0.826-0.933),sensitivity was 71.3%,specificity was 98.2%.3.There was no statistically significant difference in the general data of asthma patients with different severity levels(P>0.05).There was a statistically significant difference in Fe NO,Ca NO,and EOS among patients with asthma of different severity(P<0.05).Fe NO,Ca NO,and EOS in patients with severe severity were higher than those in patients with mild severity,with significant differences(P<0.05).4.Spearman rank correlation analysis showed that Fe NO,Ca NO and EOS were positively correlated with asthma severity(P<0.05),and the correlation coefficients were 0.538、0.460and 0.608 respectively.Conclusion:1.Fe NO,Ca NO,and EOS have certain value in the diagnosis of adult bronchial asthma,and have guiding significance for clinicians.2.When each index is applied alone,the diagnostic efficiency of Fe NO is the highest(AUC=0.874,95%CI:0.820-0.928);The combined detection of Fe NO+Ca NO+EOS has no significant advantage over the single detection of diagnostic efficacy.3.The more severe the condition of patients with bronchial asthma,the higher the levels of Fe NO,Ca NO,and EOS,which can be used as a tool to assess the severity of asthma.