哮喘儿童治疗前后呼出气一氧化氮变化及与肺功能、外周血嗜酸性粒细胞关系的临床研究

Clinical study on the relationship of exhaled nitric oxide(FENO)changes before and after treatment with lung function and peripheral blood eosinophils(EOS)in asthmatic children

目的：探讨哮喘儿童治疗前后呼出气一氧化氮（FENO ）变化及与肺功能、外周血嗜酸性粒细胞（EOS ）关系的临床研究。方法选取2012年9月至2013年6月于贵州省人民医院哮喘门诊就诊的初治哮喘患儿40例，年龄5～12岁（未系统治疗，近一月未使用激素及其他药物如孟鲁司特钠、氨茶碱等），20例哮喘急性发作期，20例哮喘非急性发作期，分别测定FENO、肺功能、外周血EOS计数。经沙美特罗替卡松治疗1月后 FENO、肺功能的复测。选取15例正常同龄儿童（无哮喘、鼻炎、过敏史，近2周无呼吸道感染史）FENO、外周血EOS计数、肺功能作为对照，分析治疗前后FENO的变化及其与肺功能 FEV 1％、外周血 EOS 计数的相关性。结果哮喘儿童急性发作期 FENO （44．86±16．88） ppb ，非急性发作期FENO （33．35±16．88） ppb ，均高于正常儿童，急性发作组高于非急性发作组，但FENO与肺功能无明显相关性，亦与外周血EOS无明显相关性，治疗后 FENO明显降低。结论 FENO在哮喘管理中需与肺功能、外周血嗜酸性粒细胞等指标联合应用。

Objective To find out changes the exhaled nitric oxide （FENO） in asthmatic children before and after treatment and the relationship of FENO with lung function and peripheral blood eosin-ophils （EOS） .Methods A total of 40 children which were 20 cases of acute asthma exacerbation ,20 cases of non-acute asthma exacerbation ,and aged 5-12 years old that had not received any systematic treatment ,had not used any hormone or other drugs such as Montelukast Sodium and aminophylline , etc .within one month with newly diagnosed asthma from September 2012 to June 2013 in the Guizhou Provincial People＇s Hospital＇s asthma clinic were included in the studies .Their FENO ,lung function , peripheral blood EOS counts were measured respectively .After one month＇s treatment with Salmeterol fluticasone propionate ,FENO ,lung function were reexamined and measured again .FENO ,peripheral blood EOS counts and pulmonary function of 15 normal children with the same age which were no asthma ,rhinitis ,allergies history ,no respiratory infections history within two weeks were treated as control group .Analyzed the FENO changes ,and its correlation between lung function FEV1% and peripheral EOS count before and after treatment .Results Children with acute asthma exacerbation , FENO were （44 .86 ± 16 .88）ppb .Children with non-acute asthma exacerbation ,FENO were （33 .35 ± 16 .88）ppb .Both were higher than that in normal children ,acute exacerbation group had much higher value than that in the non-acute exacerbation group .However ,there was no significant correla-tion between FENO and lung function or peripheral blood EOS .FENO was significantly reduced after treatment .Conclusion FENO in asthma treatment management requires being in joint use with lung function and peripheral blood eosinophils and other indicators .