Analysis Of The Diagnostic Value Of Exercise Challenge Test In Children With Chest Tightness Variant Asthma

Objective:To explore and analyze the diagnostic value of exercise challenge test in children with chest tightness variant asthma（CTVA）,and to provide a new method for clinical diagnosis and differential diagnosis.Methods:Eighty-nine children with complaints of chest tightness/sighing breath,except for other organic diseases,were selected from the Department of Pediatric Respiratory Medicine,Shengjing Hospital,China Medical University,from April 2020 to January 2021,and all children had completed exhaled nitric oxide measurement（FeNO）,routine pulmonary ventilation function tests,laboratory tests（including routine blood and serum total Ig E tests）and Children with suspected CTVA were given anti-asthma treatment such as inhaled glucocorticoids and inhaled bronchodilators,and were followed up 3 months after the initial diagnosis.curves to analyze the diagnostic value of the exercise excitation test and the indexes with statistically significant differences between the two groups for the diagnosis of chest congestion variant asthma in children.Results:There was no statistically significant difference in the comparison of conventional lung function indexes FVC,FEV₁,FEV₁/FVC%,MEF50%,MEF25%,and PEF between the two groups,and the serum total Ig E value was higher in the CTVA group than in the control group（p<0.05）.the median value of FeNO was 20.0 ppb in the CTVA group（12.0,41.0）,which was higher than in the control group（p<0.05）,and the median percentage decrease in FEV₁after exercise excitation was 10.5%（4.7%,22.0%）in the CTVA group,which was higher than that in the control group,and the difference was statistically significant.Binary logistic regression analysis of factors that may affect the diagnosis of CTVA revealed that FeNO value and percentage of FEV₁decrease after exercise excitation were the risk factors affecting the diagnosis of CTVA.The area under the curve was 0.777 and 0.745,respectively.The best value of FeNO for the diagnosis of CTVA was 17.5 ppb,with a sensitivity of 72.7%and specificity of 80.8%;the best value of FEV1 decrease percentage after exercise excitation for the diagnosis of CTVA was10.0%,with a sensitivity of 62.3%and specificity of 96.2%The sensitivity of the combined diagnosis of CTVA was 81.8%,and the specificity was 87.2%.Conclusion:Exhaled nitric oxide measurement and exercise challenge test are valuable for the diagnosis and differential diagnosis of chest distress variant asthma in children,and the combination of the two can improve the sensitivity of exercise excitation test for the diagnosis of CTVA.