Abstract: Objective To investigate the expression levels of exhaled nitric oxide(FeNO),total immunoglobulin E(IgE) and regulatory T cells(Treg) in allergic asthma children,and the clinical value of combined detection. Methods A total of 600 children with allergic asthma in Dongchangfu Maternal and Child Health Care Hospital were selected as the study group from March to November in 2018,and 100 healthy children at the same time were selected as control group.The levels of FeNO,total IgE and Treg were tested and compared between the two groups.The diagnostic efficacy of three separate detection methods and the combined detection for children with allergic asthma was calculated separately,and the diagnostic value was analyzed by ROC curve. Results The total IgE and FeNO levels in study group were significantly higher than those of the control group,while Treg level was lower than that in control group(P＜0.05).The levels of FeNO and total IgE in peripheral blood were positively correlated with the severity of allergic asthma in children(r=0.562,0.591,P＜0.05),while there was a negative correlation between Treg level and asthma severity(r=-0.569,P＜0.05).The specificity of Treg for allergic asthma children was significantly higher than that of FeNO and total IgE(P＜0.05).The sensitivity and negative predictive value of parallel combined detection were significantly higher than those of the single test and serial combination test(P＜0.05).The specificity and positive predictive value of the serial combined test were significantly higher those of the parallel combined test(P＜0.05).The areas under the curve for parallel and series combined detection of FeNO,total IgE,Treg were 0.938 and 0.917,respectively. Conclusions FeNO,total IgE and Treg levels in children with allergic asthma are associated with the severity of asthma and the severity of asthma.The diagnostic value of allergic asthma in children can be improved by parallel combined detection or serial combined detection of the three indicators.

Key words: allergic asthma, childhood asthma, exhaled nitric oxide, IgE, regulatory T cells

摘要： 目的 探究呼出气一氧化氮(FeNO)、总免疫球蛋白E(IgE)、调节性T细胞(Treg)在儿童过敏性哮喘患儿血清中的表达及其联合检测的临床价值。方法 选择2018年3-11月聊城市东昌府区妇幼保健院门诊中的过敏性哮喘患儿600例作为研究组,选择同期100例健康儿童作为对照组。检测并比较两组FeNO、总IgE以及Treg水平。分别计算3种检测手段单独检测和联合检测对于儿童过敏性哮喘的诊断效能,采用ROC曲线分析其诊断价值。结果 研究组的FeNO和外周血中的总IgE高于对照组,而外周血中Treg显著低于对照组(P＜0.05)。FeNO和外周血总IgE与小儿过敏性哮喘的严重程度呈正相关(r=0.562、0.591,P＜0.05),Treg与哮喘严重程度呈负相关(r=-0.569,P＜0.05)。Treg 对于儿童过敏性哮喘检测的特异度显著高于FeNO和总IgE(P＜0.05),平行联合检测的敏感度和阴性预测值显著高于单项检测和系列联合检测(P＜0.05),而系列联合检测的特异度和阳性预测值显著高于平行联合检测(P＜0.05)。FeNO、总IgE、Treg平行和系列联合检测的曲线下面积分别为0.938和0.917。结论 过敏性哮喘患儿的FeNO、总IgE、Treg水平与哮喘严重程度和病情分级相关。平行联合检测或系列联合检测可提高在儿童过敏性哮喘诊断中的价值。

关键词: 过敏性哮喘, 小儿哮喘, 呼出气一氧化氮, 免疫球蛋白E, 调节性T细胞