5～14岁哮喘患儿呼出气一氧化氮检测与气道可逆性相关性研究

Correlation between fraction of exhaled nitric oxide and airway reversibility in asthmatic children aged 5 to 14

目的探讨哮喘患儿呼出气一氧化氮(Fe NO)水平与气道可逆性的相关性及其在哮喘患儿病情评估中的临床意义。方法选取2014年11月至2015年11月于中国医科大学附属盛京医院小儿呼吸内科门诊就诊的5~14岁哮喘患儿161例,根据病情分为过敏组与非过敏组,2组均进行Fe NO及支气管舒张试验测定,分析2组患儿Fe NO水平与支气管舒张改善率的相关性。结果 (1)过敏组的哮喘患儿Fe NO水平明显高于非过敏组(P=0.002)。(2)过敏组的哮喘患儿Fe NO水平与支气管舒张的改善率呈显著正相关(P<0.05),与基础肺功能1秒用力呼气容积占预计值的百分比(FEV_1%)、1秒率占预计值的百分比(FEV_1/FVC%)、50%用力呼气流速占预计值的百分比(FEF50%)、25%用力呼气流速占预计值的百分比(FEF25%)、中段呼气流速占预计值的百分比(FEF75/25%)呈负相关(P<0.05),与用力肺活量占预计值的百分比(FVC%)、用力呼气峰流速占预计值的百分比(PEF%)、75%用力呼气流速占预计值的百分比(FEF75%)无明显相关性(P>0.05);(3)非过敏组的哮喘患儿Fe NO水平与支气管舒张改善率及基础肺功能均无明显相关性(P>0.05)。结论对于存在过敏体质的哮喘患儿,Fe NO水平与气道可逆性存在显著正相关,可作为该类哮喘患儿预测气道可逆性及评估哮喘病情的一个良好的无创性指标。而对于无过敏体质的哮喘患儿,Fe NO水平则不能有效反映其气道可逆性变化。

Objective To explore the correlation between FeNO levels and airway reversibility and its clinical signifi- cance in assessment of children with asthma. Methods A total of 161 children at 5 to14 years old with asthma admitted to pediatric respiratory outpatient of Shengjing Hospital Affiliated to China Medical University from November 2014 to November 2015 were divided into allergic group and non-allergic group according to the allergic condition. FeNO and bronchial dilatation tests were made in the two groups. The correlation between FeNO levels and improvement rate after bronehodilator in two groups was analyzed. Results （ 1 ） FeNO level in allergy group was obviously higher than that in non-allergic group （P = 0.002）. （2） FeNO level of children in allergic group was positively correlated with improveut of bronchial improvement （P 〈 0.05） , and negatively correlated with FEV1%, FEV1/FVC%, FEF50%, FEF25% and FEF75/ 25% of basic lung function（P 〈 0.05 ）, but was irrelevant to FVC%, PEF% and FEF75% of basic lung function （P 〉 0.05 ）. （3） FeNO level of children in non-allergic group was irrelevant to improvement rates of bronchial dilation and basic lung function （P 〉 0.05）. Conclusion For asthmatic children with allergic constitution, FeNO level is positively correlated with airway reversibility. It may be a good noninvasive predictor for evaluating asthma and airway reversibility in chil-dren with asthma. While for children without allergic con- stitution, FeNO level cannot indicate the airway revers- ibility effectively.