呼出气和肺泡一氧化氮水平在儿童支气管哮喘规范化管理中的应用价值

Application value of fractional exhaled nitric oxide and alveolar nitric oxide levels in standardized management of bronchial asthma in children

目的探讨呼出气一氧化氮(FeNO)和肺泡一氧化氮(CaNO)水平在儿童支气管哮喘(哮喘)规范化管理中的应用价值。方法测定36例哮喘急性发作期患儿(发作期组)和42例哮喘临床缓解期患儿(缓解期组)FeNO、CaNO水平和肺功能。其结果与25例健康儿童对照(对照组)。比较其组间差异,分析其在哮喘规范化管理中的应用价值。结果与对照组比较,发作期组患儿FeNO和CaNO水平升高,25%和50%肺活量瞬间流速(MEF25和MEF50)降低(P<0.05)。缓解期组患儿FeNO、MEF25和MEF50水平均与对照组相仿(P>0.05),但CaNO水平仍然高于对照组(P<0.05)。发作期组和缓解期组的CaNO与FeNO无明显相关性(P>0.05),FeNO与MEF50和MEF25亦无明显相关(P>0.05);CaNO与MEF25呈负相关(r_s=-0.383,P<0.05)。结论儿童哮喘规范化管理中,综合检测FeNO和CaNO水平对于哮喘防治有积极指导意义。

Objective To explore the application value of fractional exhaled nitric oxide(FeNO)and alveolar nitric oxide(CaNO)levels in standardized management of the children with bronchial asthma.Methods The levels of FeNO and CaNO were detected in 36 children with asthma in acute attack(group A),42 children with asthma in clinical remission stage(group B)and 25 healthy children(group C).The pulmonary function was tested as well.The differences in the levels of FeNO,CaNO and pulmonary function tests were compared among the three groups.The application value of FeNO and CaNO in standardized management of the children with bronchial asthma was analyzed.Results Compared with group C,the levels of FeNO and CaNO were higher and the levels of instant flow rates of vital capacity 50%(MEF50)and 25%(MEF25)were lower in group A(P<0.05).The levels of FeNO,MEF50 and MEF25 in group B were similar to those in group C(P>0.05).But CaNO level was higher in group B than that in group C(P<0.05).The FeNO level was not significantly correlated to the CaNO in groups of A and B(P>0.05).So did the levels of MEF50 and MEF25(P>0.05).CaNO level was negatively correlated to MEF25 in groups of A and B(r_s=-0.383,P<0.05).Conclusion In the standardized management of children with bronchial asthma,comprehensive monitoring FeNO and CaNO levels has positive guiding significance for asthma prevention and treatment.