A comparative study on the value of lower airway exhaled nitric oxide combined with small airway parameters for diagnosing cough-variant asthma

被引：10

作者：

Bai, Haodong ^{[2
]}

Shi, Cuiqin ^{[2
]}

Yu, Sue ^{[2
]}

Wen, Siwan ^{[2
]}

Sha, Bingxian ^{[2
]}

Xu, Xianghuai ^{[1
]}

Yu, Li ^{[1
]}

机构：

[1] Tongji Univ, Tongji Hosp, Sch Med, Dept Pulm & Crit Care Med, 389 Xincun Rd, Shanghai 200065, Peoples R China

[2] Tongji Univ, Tongji Hosp, Sch Med, Dept Pulm & Crit Care Med, Shanghai, Peoples R China

来源：

THERAPEUTIC ADVANCES IN RESPIRATORY DISEASE | 2023年 / 17卷

基金：

中国国家自然科学基金;

关键词：

chronic cough; cough-variant asthma; FeNO200; FeNO50; small airway; DYSFUNCTION; PATHOGENESIS; SOCIETY;

D O I：

10.1177/17534666231181259

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Background:The diagnosis of cough-variant asthma (CVA) is based on bronchial provocation test, which is challenging to be conducted. Most CVA patients have type 2 airway inflammation and small airway dysfunction. FeNO200, reflecting small airway inflammation, may be used to diagnose CVA. Objective:This study aimed to explore and compare the value of lower airway exhaled nitric oxide (FeNO50, FeNO200, and CaNO) combined with small airway parameters for diagnosing CVA. Methods:Chronic cough patients who attended the clinic from September 2021 to August 2022 were enrolled and divided into CVA group (n = 71) and non-CVA (NCVA) group (n = 212). The diagnostic values of FeNO50, FeNO200, concentration of alveolar nitric oxide (CaNO), maximal mid-expiratory flow (MMEF), forced expiratory flow at 75% of forced vital capacity (FEF75%) and forced expiratory flow at 50% of forced vital capacity (FEF50%) for CVA were evaluated. Results:FeNO50 [39(39) ppb versus 17(12) parts per billion (ppb), p < 0.01], FeNO200 [17(14) ppb versus 8(5) ppb, p < 0.01] and CaNO [5.0(6.1) ppb versus 3.5(3.6) ppb, p < 0.01] in CVA group were significantly higher than those in NCVA group. The optimal cut-off values of FeNO50, FeNO200, and CaNO for diagnosis of CVA were 27.00 ppb [area under the curve (AUC) 0.88, sensitivity 78.87%, specificity 79.25%], 11.00 ppb (AUC 0.92, sensitivity 88.73%, specificity 81.60%) and 3.60 ppb (AUC 0.66, sensitivity 73.24%, specificity 52.36%), respectively. For diagnosing CVA, the value of FeNO200 was better than FeNO50 (p = 0.04). The optimal cut-off values of MMEF, FEF75%, and FEF50% for the diagnosis of CVA were 63.80% (AUC 0.75, sensitivity 53.52%, specificity 86.32%), 77.9% (AUC 0.74, sensitivity 57.75%, specificity 83.49%) and 73.50% (AUC 0.75, sensitivity 60.56%, specificity 80.19%), respectively. The AUCs of FeNO50 combined with MMEF, FEF75%, and FEF50% for the diagnosis of CVA were all 0.89. The AUCs of FeNO200 combined with MMEF, FEF75%, and FEF50% for the diagnosis of CVA were all 0.93. Conclusion:FeNO200 > 11 ppb contributed strongly for differentiating CVA from chronic cough, especially in patients with small airway dysfunction.

引用

页数：11

共 26 条

[1] ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005 [J].