Abstract：
Primary ciliary dyskinesia (PCD) is a genetic respiratory disease characterized by chronic cough, recurrent respiratory infections, and rhinosinusitis. The measurement of nasal nitric oxide (nNO) against resistance has been suggested as a sensitive screening method. However, current recommendations argue for the use of expensive, chemiluminescence devices to measure nNO. This study aimed to compare nNO measurement using three different devices in distinguishing PCD patients from healthy controls and cystic fibrosis (CF) patients and to evaluate their diagnostic precision. The study included 16 controls, 16 PCD patients, and 12 CF patients matched for age and sex. nNO measurements were performed using a chemiluminescence device (Eco Medics CLD 88sp), and two devices based on electrochemical sensors (Medisoft FeNO+ and NIOX Vero) following standardized guidelines. Correlation estimation, Bland-Altman, ROC curve, and one-way ANOVA were used to assess device differences and diagnostic performance. Significantly lower nNO output values were observed in PCD and CF patients compared to controls during exhalation against resistance. The correlation analysis showed high agreement among the three devices. ROC curve analysis demonstrated 100% sensitivity and specificity at different cut-off values for all devices in distinguishing PCD patients from controls (optimal cut-offs: EcoMedics 73, Medisoft 92 and NIOX 87 (nl min-1)). Higher nNO output values were obtained with the Medisoft and NIOX devices as compared to the EcoMedics device, with a bias of-19 nl min-1(95% CI: -73-35) and -21 nl min-1(-73-31) accordingly. These findings indicate that all three tested devices can potentially serve as diagnostic tools for PCD if device specific cut-off values are used. This last-mentioned aspect warrants further studies and consideration in defining optimal cut-offs for individual device.
摘要：
原发性纤毛运动障碍（PCD）是一种以慢性咳嗽为特征的遗传性呼吸道疾病，反复呼吸道感染,和鼻窦炎.已建议将鼻一氧化氮（nNO）抵抗抗性的测量作为一种灵敏的筛查方法。然而,目前的建议主张使用昂贵的，测量nNO的化学发光装置。这项研究旨在比较使用三种不同设备的nNO测量值，以区分PCD患者与健康对照和囊性纤维化（CF）患者，并评估其诊断精度。该研究包括16个对照，16例PCD患者，和12例CF患者的年龄和性别相匹配。使用化学发光装置(EcoMedicsCLD88sp)进行nNO测量，和两个基于电化学传感器的设备（MedisoftFeNO+和NIOXVero）遵循标准化指南。相关估计，Bland-Altman,ROC曲线,和单向方差分析用于评估器械差异和诊断性能.在呼气抵抗期间,与对照相比,在PCD和CF患者中观察到显著更低的nNO输出值。相关性分析显示三个设备之间具有很高的一致性。ROC曲线分析在区分PCD患者与对照的所有装置(最佳截止:EcoMedics73、Medisoft92和NIOX87(nlmin-1))中,在不同截止值下显示100%的灵敏度和特异性。与EcoMeds设备相比，Medisoft和NIOX设备获得了更高的nNO输出值，相应的偏差为-19nlmin-1(95%CI:-73-35)和-21nlmin-1(-73-31)。这些发现表明,如果使用设备特定的截止值,则所有三个测试的设备都可以潜在地用作PCD的诊断工具。最后提到的这一方面需要进一步的研究和考虑，以确定单个设备的最佳截止值。
