Citation: | LI Yang, ZHANG Yuxiang, ZHANG Rongfang. Diagnostic value of exhaled nitric oxide, alveolar nitric oxide and eosinophils in respiratory diseases among children aged 3 to 6 years[J]. Journal of Clinical Medicine in Practice, 2024, 28(6): 74-78. DOI: 10.7619/jcmp.20233615 |
To investigate the application value of fractional exhaled nitric oxide (FeNO), alveolar nitric oxide (CaNO), and eosinophils (EOS) in the differential diagnosis of respiratory diseases in children aged 3 to 6 years in Lanzhou, Gansu Province.
A total of 360 children aged 3 to 6 years with confirmed asthma, allergic rhinitis, or lower respiratory tract infection were selected as research subjects. Spearman's rank correlation coefficient was used to evaluate the correlation between FeNO, CaNO and EOS. The diagnostic value of FeNO, CaNO, and EOS for the differential diagnosis of the three diseases was assessed through random forest models, receiver operating characteristic (ROC) curves, and multivariate Logistic regression analysis.
The median valuesof FeNO and CaNO were higher in asthmatic children than in those with other diseases. The median value of EOS was the lowest in children with allergic rhinitis, and the median values of FeNO and CaNO were the lowest in children with lower respiratory tract infection. Correlation analysis showed a positive correlation between FeNO and CaNO (r=0.59, P < 0.05), a negative correlation between FeNO and EOS (r=-0.61, P < 0.05), and a negative correlation between CaNO and EOS (r=-0.63, P < 0.05). The random forest model indicated that FeNO had the highest importance in disease classification. ROC curve analysis revealed that FeNO, CaNO, and EOS had the highest diagnostic efficiency for lower respiratory tract infection among the three diseases (with areas under the curve of 0.86, 0.91, and 1.00, respectively). The area under the curve of the multivariate Logistic regression model for diagnosing asthma was 0.96, with a sensitivity of 0.902 and a specificity of 0.881.
FeNO, CaNO and EOS demonstrate good potential in the differential diagnosis of asthma, allergic rhinitis, and lower respiratory tract infection in children aged 3 to 6 years in Lanzhou. Furthermore, the multivariate Logistic regression model based on these three factors can effectively improve the diagnostic accuracy of asthma.
[1] |
洪建国. 我国儿童哮喘流行病学和诊治状况[J]. 中华医学信息导报, 2020, 35(2): 22-22.
|
[2] |
WISE S K, DAMASK C, ROLAND L T, et al. International consensus statement on allergy and rhinology: Allergic rhinitis-2023[J]. Int Forum Allergy Rhinol, 2023, 13(4): 293-859.
|
[3] |
ZHU H Y, HAO C L, YU X M, et al. Fractional exhaled nitric oxide (FeNO) integrating airway hyperresponsiveness (AHR) examination promotes etiologic diagnosis and treatment for children with chronic cough[J]. Med Sci Monit, 2021, 27: e928502.
|
[4] |
CELIS-PRECIADO C A, LACHAPELLE P, COUILLARD S. Exhaled nitric oxide (FeNO): bridging a knowledge gap in asthma diagnosis and treatment[J]. Clin Exp Allergy, 2023, 53(8): 791-793. doi: 10.1111/cea.14374
|
[5] |
BARAÑSKI K, ZEJDA J E. Screening accuracy of FeNO measurement for childhood asthma in a community setting[J]. Children, 2022, 9(6): 858. doi: 10.3390/children9060858
|
[6] |
SCHNEIDER A, FADERL B, SCHWARZBACH J, et al. Prognostic value of bronchial provocation and FENO measurement for asthma diagnosis: results of a delayed type of diagnostic study[J]. Respir Med, 2014, 108(1): 34-40. doi: 10.1016/j.rmed.2013.11.008
|
[7] |
李芮, 董晓艳, 蒋鲲, 等. 口鼻呼出气一氧化氮检测在儿童支气管哮喘控制评估及过敏性鼻炎诊断中的应用[J]. 中国当代儿科杂志, 2022, 24(1): 90-95. https://www.cnki.com.cn/Article/CJFDTOTAL-DDKZ202201013.htm
|
[8] |
SCHNEIDER A, BRUNN B, HAPFELMEIER A, et al. Diagnostic accuracy of FeNO in asthma and predictive value for inhaled corticosteroid responsiveness: a prospective, multicentre study[J]. EClinicalMedicine, 2022, 50: 101533. doi: 10.1016/j.eclinm.2022.101533
|
[9] |
MUNTEAN I A, BOCSAN I C, VESA S, et al. Could FeNO predict asthma in patients with house dust mites allergic rhinitis[J]. Medicina, 2020, 56(5): 235. doi: 10.3390/medicina56050235
|
[10] |
NAKWAN N, THIDARAT RUKLERD T, PERKLEANG T, et al. The levels and correlations of FeNO, blood eosinophils and lung function in well-controlled asthma[J]. Adv Respir Med, 2022, 90(3): 183-192. doi: 10.5603/ARM.a2022.0015
|
[11] |
高永伟. 呼出气一氧化氮检测在小儿支气管哮喘早期诊断及病情评估中的应用[J]. 实用临床医药杂志, 2020, 24(3): 90-93. doi: 10.7619/jcmp.202003026
|
[12] |
LIPWORTH B, KUO C R, CHAN R. 2020 Updated Asthma Guidelines: clinical utility of fractional exhaled nitric oxide (Feno) in asthma management[J]. J Allergy Clin Immunol, 2020, 146(6): 1281-1282. doi: 10.1016/j.jaci.2020.03.006
|
[13] |
WANG J, WANG W T, LIN H, et al. Role of pulmonary function and FeNO detection in early screening of patients with ACO[J]. Exp Ther Med, 2020, 20(2): 830-837.
|
[14] |
任莉, 杨俊. 呼出气一氧化氮在儿童哮喘管理中的临床价值[J]. 实用临床医药杂志, 2022, 26(5): 96-99. doi: 10.7619/jcmp.20214064
|