| Objective:To investigate the difference of FeNO,total IgE and eosinophil count in suspected asthma patients and healthy people in adults,and to further explore the application value of FeNO in adult asthma.Methods:A total of 180 suspected asthmatic patients from the Department of Respiratory Medicine and 20 healthy people from the examination center were enrolled in the study.All of them were measured by FeNO,total IgE and eosinophil,finally statistics and analysis of the data.Combined with the patient's history and symptoms,the "gold standard" for the diagnosis of asthma is that Bronchial diastolic test or Bronchial provocation test results were positive.The ROC curve was drawn and the diagnostic value of FeNO and total IgE in bronchial asthma were evaluated and the optimal thresholds were identified.Eleven patients with good compliance in the asthma group were enrolled in the further study which the patients were uniformly treated with "Budesonide and Formoterol Fumarate Powder for Inhalation(160 ug)" for 1 week and the levels of FeNO,total IgE and EOS counts were measured again after treatment,then compare the changes of results.Results:Among the 180 patients,a total of 101 asthmatic patients were enrolled in the Asthmatic group,and 79 patients were included in the Non-asthmatic group.Among the asthmatic patients,76 patients with typical asthma were included in the Typical asthma group and 25 patients with cough variant asthma were included in the CVA group,20 healthy subjects were included in the Health group.The levels of FeNO in asthmatic group were significantly higher than those in healthy group and non-asthmatic group(P<0.05),the difference was statistically significant.There was no significant difference between normal group and non-asthmatic group(P>0.05),there was also no difference between Typical asthma group and CVA group(P>0.05).The total IgE values in the Asthma group were significantly higher than those in the Healthy group and the Non-asthma group(P<0.05),The difference was statistically significant.There was no significant difference between the Healthy group and the Non-asthma group(P>0.05).The total IgE was significantly higher in Typical asthma group than in CVA group(P<0.05),the difference was statistically significant.There was no significant difference in eosinophil count between each groups(P>0.05).The area under the ROC curve of FeNO is 0.764,and the confidence interval of 95% is(0.694,0.833),the optimal cutoff point is 22.5 ppb,the sensitivity is 0.624,the specificity is 0.861,the positive predictive value is 85.13% and the negative predictive value is 64.15%.The area under the ROC curve of total IgE was 0.752 and the confidence interval of 95% is(0.681,0.824),the optimal cutoff point is 78.35 IU / mL,the sensitivity is 0.683,the specificity is 0.81,the predicted value is 82.14% and the negative predictive value is 66.67%.After 1 week of treatment,the levels of FeNO in 11 patients with asthma were significantly reduced(P<0.05),the difference was statistically significant.The total IgE and EOS count were no significant changes aftertreatment(P>0.05).Conclusion:FeNO and total IgE are valuable for the diagnosis of bronchial asthma,but FeNO is more valuable than total IgE in the differential diagnosis of cough patients and in assessing the responsiveness of inhaled glucocorticoid therapy,whereas the reference value of EOS counts for diagnosis and treatment of asthma is small.In short,as a marker of airway inflammation,FeNO is useful for the diagnosis of asthma,the differential diagnosis,the evaluation of airway inflammation,the responsiveness and compliance of inhaled glucocorticoid(ICS)therapy,and the adjustment of asthma treatment regimens,help to determine the inhaled glucocorticoid(ICS)treatment reactivity and compliance,to guide asthma treatment regimens and other aspects,it has a greater application value in adult asthma. |
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