呼出气一氧化氮在慢性过敏性肺炎诊断中的应用价值

目的 通过对比FeNO浓度在不同亚型间质性肺病患者中的差异,研究其作为慢性过敏性肺炎（CHP）诊断方法的价值.方法 收取21名CHP患者和42名其他类型间质性肺病患者,在治疗前对所有患者进行FeNO测定和肺部高分辨率CT扫描,比较不同病因间质肺病患者FeNO浓度的不同,同时结合CT扫描结果分析患者FeNO浓度与病变程度之间的关联.结果 CHP患者的FeNO浓度的中位数为43.6 ppb,明显高于其他类型间质肺病患者FeNO浓度（在特发性肺纤维化、药物性肺炎和结缔组织相关性肺纤维化患者中依次为22 ppb,23 ppb和24.7 ppb,P＜0.001）.FeNO浓度为36.7 ppb可作为鉴别CHP与其他3种间质性肺病亚型的cut-off值,其敏感性和特异性分别为85.7%和88.1%.另外,CHP患者支气管与肺泡病变程度与其FeNO浓度间无相关联系（P〉0.05）.结论 FeNO浓度在CHP患者中明显高于其他亚型间质性肺病患者,可作为有效、快速、简便的CHP临床诊断方法.

The value of FeNo in diagnosis of chronic hypersensitivity pneumonitis

Objective Aim to evaluate the value of FeNO test in diagnosis of chronic hypersensitivity pneumonitis （CHP） via compairing the difference in FEN（） concentrations between each subtype of interstitial lung disease （ILD）. Methods 21 patients with CHP and 42 patients with other subtypes of ILD were recruited. Computed tomography （CT） scan and FeNO levels were measured and analysed to identify the differences in FeNO between different subtypes of ILD and the relationship between FEN（） levels with the location or extent of lesions. Results The median FeNO val- ue of patients with chronic CHP was 43.6 ppb,higher than that of the other groups （22 ppb in IPF,23 ppb in drug-in duced pneumonia,and 24.7 ppb for CTD-ILD,P0. 001）. At the cut-off value of 36.7 ppb, the optimal sensitivity and specificity to diagnose HP with FeNO were respectively 85.7 and 88.1 . On CT scans, the location and extent of the lesions were not associated with FENO values （P〉0.05）. Conclusion FeNO could be used as a effective tool for dif- ferentiating CHP from other types of ILD.