2岁以下婴幼儿鼻腔呼出气一氧化氮水平检测及其临床意义

Detection of nasal nitric oxide level in infants younger than 2 years old and its clinical significance

目的探讨检测2岁以下婴幼儿鼻腔呼出气NO(NNO)水平的临床意义。方法对2014年3月至2015年3月在上海东方医院儿科门诊就诊的50例2岁以下婴幼儿进行NNO水平检测,根据是否有喘息分为喘息组19例和非喘息组31例,根据哮喘预测指数(API)分为API阴性组20例和API阳性组30例,对各组婴幼儿的NNO水平进行统计分析。结果 50例受试者检测成功。2岁以下婴幼儿中年龄与NNO水平有相关性(r=0.481,P=0.001);API阳性组NNO水平显著高于API阴性组,差异有显著统计学意义(Z=-3.962,P<0.01),而喘息组和无喘息组的NNO水平比较差异无统计学意义(Z=-0.440,P=0.660);NNO与嗜酸性粒细胞(EOS)计数呈正相关(r=0.343,P=0.015)。结论 2岁以下婴幼儿检测NNO成功率高,在临床上具有可行性,具有哮喘高危因素者其NNO水平亦高,NNO水平对预测2岁内喘息儿发展为持续性哮喘具有一定的指导意义。

Objective To explore the clinical significance of the detection of nasal nitric oxide （NNO） level in infants younger than 2 years old. Methods A total of 50 infants younger than 2 years old, who admitted to Department of Pediatrics of Shanghai East Hospital from March 2014 to March 2015, were divided into the gasping group （n=19） and the non-gasping group （n=31） according to whether they had gasp; these infants also were divided into the API nega- tive group （n=20） and the API positive group （n=30） by the Asthma Predictive Index （API）. The NNO levels of these groups were statistically analyzed. Results The medical records of these 50 cases were successfully collected. There was a positive correlation between age and NNO level in infants younger than 2 years old （r=0.481, P=-0.001）. The NNO level in API positive group was significantly higher than that in the API negative group （Z=-3.962, P〈0.001）. There was no sig- nificant difference between the gasping group and non-gasping group in the NNO level （Z=-0.440, P=-0.660）. There was a positive correlation between NNO level and eosinophils （EOS） counting （r=0.343, P=0.015）. Conclusion The detection success rate of NNO level in infants younger than 2 years old is high, which is clinically feasible. The NNO level of in- fants who have the asthma high risk factors is also high, which is helpful in predicting the potential development from gasp to persistent asthma in infants younger than 2 years old.