血清总IgE、EOS、LDH和呼出气一氧化氮对过敏性鼻炎合并支气管哮喘的预测价值

doi:10.11958/20250328

天津医药 ›› 2025, Vol. 53 ›› Issue (4): 360-364.doi: 10.11958/20250328

血清总IgE、EOS、LDH和呼出气一氧化氮对过敏性鼻炎合并支气管哮喘的预测价值

朱永红(), 巴军凤()

安徽省淮北市妇幼保健院儿一科（邮编235000）

收稿日期:2025-01-19 修回日期:2025-02-20 出版日期:2025-04-15 发布日期:2025-04-17
通讯作者: ^△ E-mail：bajunfeng2024@126.com
作者简介:朱永红（1982），女，主治医师，主要从事儿童呼吸、过敏性疾病方面研究。E-mail：13665610845@139.com
基金资助:
安徽省卫生健康委科研项目(AHWJ2021b104)

Predictive value of serum total IgE, eosinophils, diamine oxidase and fractional exhaled nitric oxide in allergic rhinitis combined with bronchial asthma

ZHU Yonghong(), BA Junfeng()

Pediatric Internal Medicine Department, Huaibei Maternal and Child Health Hospital, Huaibei 235000, China

Received:2025-01-19 Revised:2025-02-20 Published:2025-04-15 Online:2025-04-17
Contact: ^△ E-mail：bajunfeng2024@126.com

朱永红, 巴军凤. 血清总IgE、EOS、LDH和呼出气一氧化氮对过敏性鼻炎合并支气管哮喘的预测价值[J]. 天津医药, 2025, 53(4): 360-364.

ZHU Yonghong, BA Junfeng. Predictive value of serum total IgE, eosinophils, diamine oxidase and fractional exhaled nitric oxide in allergic rhinitis combined with bronchial asthma[J]. Tianjin Medical Journal, 2025, 53(4): 360-364.

摘要/Abstract

摘要：

目的探讨血清总IgE、嗜酸性粒细胞（EOS）、乳酸脱氢酶（LDH）联合呼出气一氧化氮（FeNO）水平对过敏性鼻炎（AR）合并支气管哮喘（BA）的预测价值。方法 127例AR患儿根据是否合并BA分为AR组（84例）和AR+BA组（43例），另选取55例健康体检儿童作为对照组。比较3组的一般资料和总IgE、EOS比例、LDH水平、FeNO水平，分析各指标与疾病症状持续时间和鼻部症状评分的相关性，并进行受试者工作特征（ROC）曲线分析，评估各指标对AR及AR+BA的预测价值。结果 AR组和AR+BA组的总IgE、EOS比例、LDH、FeNO水平均高于对照组（P<0.05），AR+BA组的总IgE、EOS比例、FeNO水平均高于AR组（P<0.05）。相关性分析显示，AR组和AR+BA组总IgE、EOS比例、FeNO水平与患者疾病症状持续时间和症状评分呈正相关（P<0.05）。AR组患儿LDH水平与疾病症状持续时间和鼻部症状评分呈正相关（P<0.05），但在AR+BA组中与症状持续时间和BA症状评分无线性相关性（P>0.05）。ROC曲线分析结果显示，总IgE、FeNO、EOS比例和LDH对AR及AR+BA均有一定的预测价值，总IgE对AR和AR+BA预测价值均较高[曲线下面积（AUC）分别为0.971和0.800]。联合检测总IgE、EOS比例、LDH、FeNO对AR+BA的预测价值最好（AUC=0.904）。结论血清总IgE、LDH、EOS比例、FeNO水平均可作为预测AR合并BA的有效指标，联合检测可提高预测的准确性，为临床早期识别和干预AR+BA提供参考依据。

关键词: 鼻炎, 过敏性, 哮喘, 总IgE, 中性粒细胞, 乳酸脱氢酶, 呼出气一氧化氮

Abstract:

Objective To investigate the predictive value of serum total IgE, eosinophil (EOS) ratio, lactate dehydrogenase (LDH) and exhaled nitric oxide (FeNO) levels in allergic rhinitis (AR) complicated with bronchial asthma (BA). Methods A total of 127 children with AR were divided into the AR group (84 cases) and the AR+BA group (43 cases) based on the presence of BA. Another 55 healthy children were selected as the control group. General data, total IgE, EOS ratio, LDH and FeNO levels were compared between the three groups. The correlation between these indicators and duration of disease symptoms, nasal symptom scores were analyzed. Receiver operating characteristics (ROC) curve analysis was performed to evaluate the predictive value of these indicators for AR and AR+BA. Results Total IgE, EOS ratio, LDH and FeNO levels were significantly higher in the AR group and the AR+BA group than those in the control group (P<0.05). The total IgE, EOS ratio and FeNO levels were higher in the AR+BA group than those in the AR group (P<0.05). Correlation analysis showed that total IgE, EOS ratio and FeNO levels were positively correlated with the duration of disease symptoms and symptom scores in the AR group and the AR+BA group (P<0.05). In the AR group, LDH levels were positively correlated with the duration of disease symptoms and symptom scores (P<0.05), but in the AR+BA group, there was no significant correlation between the duration of BA symptoms and symptom scores (P>0.05). ROC curve analysis indicated that total IgE, FeNO, EOS ratio and LDH all had predictive values for both AR and AR+BA. The predictive value of total IgE for AR and AR+BA was higher (AUC=0.971 and 0.800). Combined detection of total IgE, EOS ratio, LDH and FeNO had the best predictive value for AR+BA (AUC=0.904). Conclusion Serum levels of total IgE, LDH, EOS ratio and FeNO can be served as effective indicators for predicting AR complicated with BA. Combined detection can improve the accuracy of prediction and provide a reference for early clinical identification and intervention in AR+BA.

Key words: rhinitis, allergic, asthma, total IgE, neosinophils, lactate dehydrogenase, exhaled nitric oxide

中图分类号:

R725.62，R765.21

图/表 7

参考文献 19

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组别		n	年龄/岁	性别		BMI/（kg/m2）
组别		n	年龄/岁	男	女	BMI/（kg/m2）
对照组		55	7.0±2.5	32（58.2）	23（41.8）	17.5±2.9
AR组		84	7.2±2.8	53（63.1）	31（36.9）	17.8±3.2
AR+BA组		43	7.5±3.1	28（65.1）	15（34.9）	18.1±3.5
F或χ²			0.389	0.560		0.431
组别	家族过敏史			病程/月	本次症状持续时间/d	鼻部症状评分/分
组别	有		无	病程/月	本次症状持续时间/d	鼻部症状评分/分
对照组	18（32.7）		37（67.3）	-	-	2.3±1.2
AR组	63（75.0）^a		21（25.0）	16.5±4.8	8.3±1.6	6.5±1.8^a
AR+BA组	39（90.7）^ab		4（9.3）	18.2±5.6	12.5±4.3	7.2±2.1^ab
F、χ²或t	41.815^＊＊			12.579^＊＊	6.929^＊＊	129.481^＊＊

组别		n	年龄/岁	性别		BMI/（kg/m2）
组别		n	年龄/岁	男	女	BMI/（kg/m2）
对照组		55	7.0±2.5	32（58.2）	23（41.8）	17.5±2.9
AR组		84	7.2±2.8	53（63.1）	31（36.9）	17.8±3.2
AR+BA组		43	7.5±3.1	28（65.1）	15（34.9）	18.1±3.5
F或χ²			0.389	0.560		0.431
组别	家族过敏史			病程/月	本次症状持续时间/d	鼻部症状评分/分
组别	有		无	病程/月	本次症状持续时间/d	鼻部症状评分/分
对照组	18（32.7）		37（67.3）	-	-	2.3±1.2
AR组	63（75.0）^a		21（25.0）	16.5±4.8	8.3±1.6	6.5±1.8^a
AR+BA组	39（90.7）^ab		4（9.3）	18.2±5.6	12.5±4.3	7.2±2.1^ab
F、χ²或t	41.815^＊＊			12.579^＊＊	6.929^＊＊	129.481^＊＊

组别	n	总IgE/ （IU/mL）	EOS比例/ %	LDH/ （U/L）	FeNO/ （×10^-9）
对照组	55	76.7±36.8	2.58±1.40	188.48±32.95	15.09±7.12
AR组	84	274.7±98.8^a	4.94±2.04^a	310.57±43.50^a	33.60±9.52^a
AR+BA组	43	408.4±128.6^ab	6.44±3.25^ab	332.54±64.11^a	47.24±15.14^ab
F		157.560	37.957^＊＊	38.126^＊＊	116.250^＊＊

组别	n	总IgE/ （IU/mL）	EOS比例/ %	LDH/ （U/L）	FeNO/ （×10^-9）
对照组	55	76.7±36.8	2.58±1.40	188.48±32.95	15.09±7.12
AR组	84	274.7±98.8^a	4.94±2.04^a	310.57±43.50^a	33.60±9.52^a
AR+BA组	43	408.4±128.6^ab	6.44±3.25^ab	332.54±64.11^a	47.24±15.14^ab
F		157.560	37.957^＊＊	38.126^＊＊	116.250^＊＊

指标	AR组（n=84）		AR+BA组（n=43）
指标	症状持续时间	鼻部症状评分	症状持续时间	BA症状评分
总IgE	0.683^＊＊	0.725^＊＊	0.542^＊＊	0.618^＊＊
EOS比例	0.579^＊＊	0.632^＊＊	0.487^＊＊	0.553^＊＊
LDH	0.235^＊	0.287^＊	0.189	0.146
FeNO	0.712^＊＊	0.758^＊＊	0.635^＊＊	0.702^＊＊

血清总IgE、EOS、LDH和呼出气一氧化氮对过敏性鼻炎合并支气管哮喘的预测价值

Predictive value of serum total IgE, eosinophils, diamine oxidase and fractional exhaled nitric oxide in allergic rhinitis combined with bronchial asthma

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指标	AUC	95%CI	截断值	敏感度/ %	特异度/ %	约登指数
LDH	0.853	0.783~0.907	251.6 U/L	76.2	80.0	0.562
EOS比例	0.831	0.758~0.889	3.4%	78.6	74.5	0.531
FeNO	0.948	0.897~0.978	24.8×10^-9	82.1	92.7	0.749
总IgE	0.971	0.927~0.992	147.5 IU/mL	91.7	98.2	0.899

指标	AUC	95%CI	截断值	敏感度/ %	特异度/ %	约登指数
LDH	0.543	0.452~0.632	320.4 U/L	60.5	54.8	0.153
EOS比例	0.650	0.560~0.732	6.5%	55.8	51.0	0.368
FeNO	0.764	0.680~0.835	46.3×10^-9	60.5	90.5	0.510
总IgE	0.800	0.720~0.866	343.7 IU/mL	72.1	79.8	0.519
联合检测	0.904	0.839~0.949	-	83.7	83.3	0.670

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