呼出气一氧化氮检测在缓解期儿童哮喘合并鼻炎中的价值

Significance of exhaled nitric oxide measurement in remitting childhood asthma with concurrent remitting rhinitis

目的探讨呼出气一氧化氮(FeNO)检测用于评估缓解期哮喘合并缓解期过敏性鼻炎患儿病情的价值。方法选取214例处于临床缓解期哮喘儿童,按照有无合并过敏性鼻炎及有无进行规范化治疗分为哮喘治疗组、哮喘合并鼻炎治疗组、哮喘未治疗组及哮喘合并鼻炎未治疗组。同时记录FeNO及引起FEV1下降20%时的激发剂累计浓度(PC20FEV1)数值。结果哮喘未治疗组PC20FEV1数值高于哮喘合并鼻炎未治疗组,差异有统计学意义;两组FeNO差异无统计学意义。哮喘治疗组与哮喘合并鼻炎治疗组FeNO及PC20FEV1数值差异均无统计学意义。哮喘合并鼻炎治疗组PC20FEV1数值明显高于未治疗组,FeNO数值明显低于未治疗组。哮喘治疗组仅FeNO数值明显低于未治疗组,二者PC20FEV1数值差异无统计学意义。结论对怀疑合并有临床缓解期过敏性鼻炎的哮喘患儿进行病情评估时,FeNO检测具有重要的价值。

Objective To evaluate the value of exhaled nitric oxide in the severity evaluation of asthmatic children with remitting rhinitis. Methods A total of 214 asthmatic children were randomly allocated to a untreated control and a conventional treatment group. Patients in each of the two subclasses were classified as asthma with concurrent rhinitis and asthma without concurrent rhinitis. Values of the 20% fall in forced expiratory volume in 1 second （PC2oFEVt） and fractional exhaled nitric oxide （FeNO） were measured. Results The PC20FEVt level was significantly higher in untreated asthma patients without rhinitis than in those with concurrent rhinitis （P〈0.05）, while FeNO was not significantly different between these two groups （P〉0.05）. There were no significant differences in both FeNO and PC20FEVt between treated asthma patients with and without concurrent rhinitis （P〉0.05）. PC20FEVt was significantly increased （P〈0.05） but FeNO was significantly decreased （P〈0.05） in asthma patients with concurrent rhinitis after conventional treatment. In asthmatic children without concurrent rhinitis, treatment significantly decreased the level of FeNO （P〈0.05） but had not effect on PC20FEVt （P〉0.05）. Conclusions Exhaled nitric oxide measurement may be useful in the severity evaluation of asthmatic children with remitting rhinitis.