北京地区学龄儿童呼出气一氧化氮调查分析

Exhaled nitric oxide levels in school children of Beijing

目的了解北京地区学龄儿童呼出气一氧化氮（eNO）水平。方法选择北京市11～18岁在校学生，采用过敏性疾病与哮喘的国际间对比研究调查问卷，通过填写问卷及现场体检对儿童进行分组（正常儿童组及曾患不同疾病儿童组），检测eNO水平、峰流速及过敏原。结果共筛选出正常儿童395名，男177名，女218名。不同性别正常儿童eNO差异无统计学意义（P均〉0．05），但与其年龄呈正相关（男性P=0．008，女性P=0．05），在男性与其身高呈正相关（P=0．02）。11—14岁、14～18岁正常儿童eNO几何均数（G）分别为11．22、14．13ppb（ppb=10^9），其95％正常值范围分别为4．17～30．20ppb、5．50-36．31ppb.曾患哮喘／喘息（68例）和曾患过敏性鼻炎（96例）儿童eNO几何均数分别是19．05ppb、14．79ppb，与正常儿童差异有统计学意义（P分别为0．001、0．008）。过敏原皮肤点刺检查阳性与阴性儿童eNO几何均数分别为16．98ppb、11．75ppb，两组间差异有统计学意义（P=0．001）。结论北京地区11～18岁正常学龄儿童eNO随年龄波动于10．72—13．80ppb，与年龄、身高呈正相关，号陛别无关。喘息性疾病、过敏性鼻炎患儿以及特应性个体eNO水平显著增加。

Objective To learn the normal values of exhaled nitric oxide （eNO） in children. Method School children in Beijing from 11 to 18 years of age were included in the study. All the students were assigned into two groups： normal group and abnormal group （with allergic disease） according to the International Study of Asthma and Allergy in Childhood questionnaires, eNO, peak expiratory flow rate and sensitization were measured. Result Totally 395 students were screened out as normal subject （ male ： 177, female： 218）. The eNO level was not significantly different between genders （P 〉 0.05）, but was associated positively with age in both male and female group （ P = 0. 008 and P = 0. 05 respectively） and associated with height in male students （ P = 0. 02 ）. The geometric mean value of eNO was 11.22 ppb （parts per billion, ppb = 109） in children aged from 11 to 14 years and 14. 13 ppb in children aged from 14 to 18 years ,with 95% confidence interval 4. 17 - 30. 20, 5.50 - 36. 31 ppb. The eNO level was significantly increased in children who ＂ever had asthma or wheezing＂ （ n = 68 ） , and children who ＂ever had rhinitis＂ （ n = 96） compared with normal subjects （ P = 0. 001 and P = 0. 008 ）. The geometric mean value of eNO was 16. 98 ppb in children with positive skin prick test and was significantly increased as compared with children with negative skin prick test with eNO level at 11.75 ppb （ P = 0. 001 ）. Conclusion eNO level varied between 10. 72 ppb and 13.80 ppb in normal children 11 - 18 years of age, and was positively associated with age and height, but not with gender, eNO level increased significantly in children with wheezing and atopy.