呼出气一氧化氮在儿童哮喘和肺炎中的水平及意义

The Levels and Significance of FeNO in Childhood Asthma and Pneumonia

目的探讨儿童哮喘及肺炎呼出气一氧化氮(FeNO)水平及其与外周血嗜酸性粒细胞(EOS)和第1秒用力呼出气量占预计值百分比(FEV1%)的相关性。方法选择2013年7月~2013年12月收治的哮喘患儿共62例。其中,急性发作期患儿33例,缓解期患儿29例。同时收集肺炎患儿21例,健康对照组21例;哮喘组、肺炎组及对照组分别测定FeNO,EOS及FEV1水平并进行统计学分析。结果①哮喘急性发作组FeNO,EOS水平分别高于缓解组和对照组,FEV1%水平低于缓解组和对照组,差异均有显著性(P<0.05)。②哮喘缓解组FeN0和EOS水平仍高于对照组,差异均有显著性(P<0.05),FEV1%水平两组间差异无显著性(P>0.05)。③肺炎组与对照组比较,FeNO,EOS及FEV1%水平差异无显著性(P>0.05)。④哮喘患儿FeNO水平与EOS呈正相关(r=0.68,P<0.05),FeNO水平与FEV1%无明显相关性(r=-0.18,P>0.05),EOS与FEV1%无明显相关性(r=-0.04,P>0.05)。⑤哮喘患儿中FeNO阳性率为82.26%,EOS阳性率为62.90%,FEV1%阳性率为41.94%(x^2=21.49,P<0.05)。结论哮喘患儿FeNO水平可反映哮喘气道嗜酸性粒细胞性炎症,且敏感性较EOS高。哮喘患者中FeNO与EOS有相关性。FeNO和EOS可用来协助鉴别过敏性炎症和普通感染。

Objective To investigate the levels of Fractional Exhaled Nitric Oxide （ FeNO） in childhood asthma and pneumonia and the relationship with peripheral blood eosinophils （ EOS） and the forced expiratory volume in one second/predicted value ratio （ FEVl%） . Methods Sixty-two children with asthma （ 33 exacerbation patients and 29 remittent patients ） and 21 children with bronchial pneumonia were collected from July to December in 2013 in the Affiliated Hospital of Weifang Medical University ,21 healthy children as control group . FeNO,EOS and FEV1 levels were measured in these three groups and statistically analysed .Results ①The levels of FeNO and EOS in exacerbation group were higher than those in remittent group and control group ,FEV1 levels were less than those in remittent group and control group（P〈0.05）.②The levels of FeNO and EOS in remittent group were still higher than those in control group （P〈0.05）,there was no statistically significant difference between the FEV1 levels in these two groups（P〉0.05）.③The levels of FeNO,EOS and FEV1 between the control group and the pneumonia group had no statistical significance （P〉0.05）.④In asthma group,the FeNO level was positively correlated with the EOS（r=0.68,P〈0.05）,the FeNO level and FEV1 had no obvious correlation（r=-0.18,P〉0.05,the EOS level and FEV1 had no obvious correlation（r=-0.04,P〉0.05）.⑤In children with asthma,the positive rates of FeNO,EOS and FEV1 were 82.26%,62.90%and 41.94%（χ2 =21.49,P〈0.05）.Conclusion FeNO has a good correlation with the EOS in patients with asthma ,and the FeNO level can reflect the eosinophil inflammation in airway of asthma patients ,but its sensitivity is higher than EOS .FeNO and EOS can be used to help identify allergic inflammation and common infections in clinical practice .