FeNO、CaNO和小气道功能检测对支气管舒张试验阴性哮喘的临床诊断价值

黄思思; 朱苗娟; 余红缨; 聂汉祥

doi:10.14188/j.1671-8852.2024.0897

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FeNO、CaNO和小气道功能检测对支气管舒张试验阴性哮喘的临床诊断价值

临床医学研究 | 更新时间：2026-11-05

- FeNO、CaNO和小气道功能检测对支气管舒张试验阴性哮喘的临床诊断价值
- Value of FeNO, CaNO, and small airway function for diagnosis of asthma with negative bronchial provocation test
- 武汉大学学报（医学版） 2025年46卷第11期页码：1455-1462
- 作者机构：
  
  武汉大学人民医院呼吸与危重症医学科湖北武汉 430060
- 作者简介：
  
  黄思思，女，1999—，医学硕士生，主要从事支气管哮喘的基础研究，E⁃mail: s15367496314@163.com
  聂汉祥，男，1971—，教授，博士生导师，主要从事支气管哮喘的临床及基础研究，E⁃mail: nhxiang@whu.edu.cn
- 基金信息：
- DOI：10.14188/j.1671-8852.2024.0897
  中图分类号： R562.2⁺5
- 收稿：2024-11-21，
  
  纸质出版：2025-11-25
- 稿件说明：
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黄思思,朱苗娟,余红缨等.FeNO、CaNO和小气道功能检测对支气管舒张试验阴性哮喘的临床诊断价值[J].武汉大学学报（医学版）,2025,46(11):1455-1462.

HUANG Sisi,ZHU Miaojuan,YU Hongying,et al.Value of FeNO, CaNO, and small airway function for diagnosis of asthma with negative bronchial provocation test[J].Medical Journal of Wuhan University,2025,46(11):1455-1462.
黄思思,朱苗娟,余红缨等.FeNO、CaNO和小气道功能检测对支气管舒张试验阴性哮喘的临床诊断价值[J].武汉大学学报（医学版）,2025,46(11):1455-1462. DOI： 10.14188/j.1671-8852.2024.0897.

HUANG Sisi,ZHU Miaojuan,YU Hongying,et al.Value of FeNO, CaNO, and small airway function for diagnosis of asthma with negative bronchial provocation test[J].Medical Journal of Wuhan University,2025,46(11):1455-1462. DOI： 10.14188/j.1671-8852.2024.0897.

摘要

目的

分析呼出气一氧化氮（FeNO）、肺泡气一氧化氮（CaNO）水平和小气道功能对支气管舒张试验阴性哮喘患者的临床诊断价值。

方法

选取200例2023年5月至2024年5月就诊于武汉大学人民医院呼吸与危重症医学科门诊的支气管哮喘初诊患者，分为支气管舒张试验阳性哮喘组（

=112）和支气管舒张试验阴性哮喘组（支气管舒张试验阴性，但支气管激发试验阳性患者）（

=88）。选择40例健康体检者作为对照。比较不同组别受试对象FeNO、CaNO和小气道功能参数水平；绘制受试者工作曲线（ROC）评价FeNO、CaNO和小气道功能对支气管舒张试验阴性，但支气管激发试验阳性哮喘的临床诊断价值。

结果

支气管舒张试验阴性组哮喘患者FeNO和CaNO水平明显高于健康对照组，但最大呼气中段流量(MMEF)占预计值百分比改变值（△MMEF%）水平明显低于健康对照组（

0.05）。FeNO水平诊断支气管舒张试验阴性哮喘的临界值为39.5 ppb（1 ppb=10

-9

），敏感度为95.0%，特异度为64.8%，ROC曲线下面积为0.826（95%

：0.757~0.895）。CaNO水平诊断支气管舒张试验阴性哮喘临界值为4.25 ppb，敏感度为55.0%，特异度为76.1%，ROC曲线下面积为0.673（95%

：0.574~0.772）。△MMEF%诊断支气管舒张试验阴性哮喘的临界值为7.5%，敏感度为51.1%，特异度为90.0%，ROC曲线下面积为0.681（0.590~0.772）。联合检测CaNO、FeNO和△MMEF%诊断支气管舒张试验阴性哮喘的敏感度为68.2%，特异度为92.5%，ROC曲线下面积为0.857（95%

：0.794~0.920）。

结论

联合检测FeNO、CaNO和△MMEF%指标有助于提高支气管舒张试验阴性哮喘的诊断水平。

Abstract

Objective

To analyze the clinical diagnostic value of fractional exhaled nitric oxide (FeNO)

concentration of alveolar nitric oxide (CaNO)

and small airway function in asthmatic patients with negative bronchial dilation test.

Methods

A total of 200 newly diagnosed patients with bronchial asthma who were admitted to the Department of Respiratory and Critical Care Medicine

Renmin Hospital of Wuhan University from May 2023 to May 2024 were selected and divided into bronchial dilation test⁃positive asthma group (

=112) and bronchial dilation test negative

but bronchial provocation test positive patients (bronchial dilation test negative asthma group) (

=88). Forty healthy people were selected as controls. The levels of FeNO

CaNO

and small airway function parameters were compared among different groups. The receiver operating characteristic curve (ROC) analysis was performed to evaluate the clinical diagnostic value of FeNO

CaNO

and small airway function in asthma with a negative bronchial dilation test but a positive bronchial provocation test.

Results

The levels of FeNO and CaNO in asthma patients with negative bronchial dilation test were significantly higher than those in the healthy control group

but the percentage change of maximal mid⁃expiratory flow curve (△MMEF%) was significantly lower than that in the healthy control group (

0.05). The cut⁃off value of FeNO level in the diagnosis of bronchial dilation test⁃negative asthma was 39.5 ppb（1 ppb=10

-9

）

the sensitivity was 95.0%

the specificity was 64.8%

and the area under the ROC curve was 0.826 (95%

: 0.757⁃0.895). The critical value of CaNO level in the diagnosis of bronchial dilation test⁃negative asthma was 4.25 ppb

the sensitivity was 55.0%

the specificity was 76.1%

and the area under the ROC curve was 0.673 (95%

: 0.574⁃0.772). The cut⁃off value of △MMEF% in the diagnosis of bronchial dilation test⁃negative asthma was 7.5%

the sensitivity was 51.1%

the specificity was 90.0%

d the area under the ROC curve was 0.681(95%

: 0.590⁃0.772). The sensitivity of combined detection of CaNO

FeNO

and △MMEF% in the diagnosis of bronchial dilation test⁃negative asthma was 68.2%

the specificity was 92.5%

and the area under the ROC curve was 0.857(95%

: 0.794⁃0.920).

Conclusion

The combined detection of FeNO

CaNO and △MMEF% improves the diagnostic level of bronchial dilation test⁃negative asthma.

关键词

Keywords

references

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