呼出气一氧化氮 外周血嗜酸性粒细胞及血清总IgE在儿童喘息性疾病诊断中的意义

The significance of exhaled nitric oxide, eosinophils and total IgE in the diagnosis of asthmatic diseases in children

目的探讨呼出气一氧化氮(FeNO)、外周血嗜酸性粒细胞(EOS)及血清免疫球蛋白E(总IgE)在儿童喘息性疾病诊断中的意义。方法选取2016年11月~2017年7月我院收治的哮喘患儿55例为哮喘组,支气管肺炎患儿55例为肺炎组,并选取同一时期到我院进行健康体检的儿童55例为健康组,收集3组儿童的一般资料;比较健康组儿童与哮喘组患儿的FeNO、EOS及血清总IgE的水平差异;对比肺炎组患儿与喘息组患儿的FeNO、EOS及血清总IgE的水平差异;对比3组儿童的各项肺功能指标。结果哮喘组患儿FeNO、EOS及血清总IgE指标均显著高于健康组(P<0.05);哮喘组患儿的FeNO、EOS及血清总IgE指标均显著高于肺炎组患儿(P<0.05);3组儿童的呼吸通气量(Vt)、呼吸频率(RR)、呼吸量/容积E(VPTEF/V)、达峰时间比(TPTEF/TE)差异无统计学意义(P>0.05)。结论 FeNO、EOS及IgE在诊断及鉴别儿童支气管哮喘时具有非常高的特异性和敏感性,此3项指标在喘息性疾病患儿中都显著升高,临床相关医护可根据以上三项指标给予患儿更加及时有效的治疗。

Objective To explore the significance of exhaled nitric oxide(FeNO), eosinophils(EOS) and immunoglobulin E(total IgE) in the diagnosis of asthmatic diseases in children. Methods From November 2016 to July 2017, 55 children with asthma were selected as asthma group, 55 children with bronchopneumonia as pneumonia group, and 55 children came to our hospital for physical examination in the same period were selected as healthy group. The general data of three groups of children were collected. The differences of FeNO, EOS and total serum IgE between healthy group and asthma group were compared. The levels of FeNO, EOS and total IgE were compared between pneumonia group and wheezing group. The lung function indexes of the three groups were compared. Results The levels of FeNO, EOS and serum IgE in asthmatic group were significantly higher than those in healthy group(P<0.05). The FeNO, EOS and total IgE in asthma group were significantly higher than those in pneumonia group(P<0.05). There was no significant difference in VT, RR, vptef/V and tptef/TE among the three groups(P>0.05). Conclusion FeNO, EOS and IgE have very high specificity and sensitivity in the diagnosis and differentiation of children’s asthma. These three indexes are significantly increased in children with asthmatic diseases. Clinical related medical care can give children more timely and effective treatment according to the above three indexes.