呼出气一氧化氮与外周血嗜酸性粒细胞在儿童哮喘中的相关性研究

Correlation study of fractional exhaled nitric oxide and peripheral blood eosinophil in childhood asthma

目的探讨哮喘患儿呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)与其与外周血嗜酸性粒细胞(eosinophils,EOS)的相关性。了解FeNO及EOS在儿童哮喘中的临床意义,并为早期临床诊断和有效治疗提供依据。方法选取2012年7月-2013年12月在临朐县人民医院儿科病房及门诊确诊的哮喘患儿45例,正常对照组26例。分别测定FeNO及EOS的水平。结果 1)哮喘急性发作组FeNO[(57.34±41.53)ppb]、EOS水平[(1.66±4.52)×109/L]分别高于缓解组[(41.48±26.96)ppb],[(0.63±0.56)×109/L]和对照组[(16.14±6.37)ppb],[(0.08±0.07)×109/L],差异均有统计学意义(P<0.05);2)哮喘缓解组FeNO和EOS水平仍高于对照组,差异均有统计学意义(P<0.05);3)哮喘组患儿的FeNO水平与外周血EOS水平呈正相关(r=0.71,P<0.05)。结论哮喘患儿FeNO水平增高,与EOS有很好的相关性,其水平可以间接反映哮喘气道嗜酸性粒细胞性炎症,且敏感性较EOS更高。哮喘缓解期气道炎症仍存在,仍需抗炎治疗,临床上可联合应用FeNO和EOS来评估哮喘病情并调整治疗方案。

Objective To discuss the correlation of fractional exhaled nitric oxide(FeNO)and peripheral blood eosinophil(EOS)in children with asthma,and to investigate the clinical significance of FeNO and EOS in asthmatic children,and to provide the basis for early diagnosis and effective treatment. Methods A total of 45 cases of children with asthma were collected from July 2012 to December 2013 in the pediatric ward and clinic of the Linqu County People’s Hospital,26 cases of normal control group.FeNO and EOS were measured respectively. Results 1)The levels of FeNO and EOS in acute asthma group[(57.34±41.53)ppb],[(1.66±4.52)×109/L]were significantly higher than those in remission group[(41.48±26.96)ppb),[(0.63±0.56)×109/L]and control group[(16.14±6.37)ppb],[(0.08±0.07)×109/L],the differences were statistically significant(P<0.05).2)The levels of FeNO and EOS in remission asthma group were still higher than those of the control group,the differences were statistically significant(P<0.05).3)The level of FeNO in asthma group was positively correlated with the level of peripheral blood EOS(r=0.71,P<0.05). Conclusions Increased FeNO levels in children with asthma had a good correlation with EOS,which can indirectly reflect the level of airway eosinophilic inflammation,and the sensitivity is higher than EOS.The remission of asthma airway inflammation is still need to be anti-inflammatory treatment.The combined use of FeNO and EOS can assess the severity and adjust the treatment plan in clinic.