中国6~18岁学龄儿童与青少年呼出气一氧化氮正常值的多中心研究

A multi-center study on the normal range of exhaled nitric oxide in 6-18-year-old children in China

目的调查中国6~18岁学龄儿童和青少年呼出气一氧化氮(FeNO)正常值范围,为中国儿童FeNO的标准建立提供数据基础。方法在中国7个行政区的16个省份进行多中心研究,通过问卷调查,确定了5949例6~18岁儿童和青少年(男3101名,女2848名)参与研究。按照美国胸科学会/欧洲呼吸协会推荐的技术标准进行FeNO测定,并探讨FeNO与性别、年龄、身高、体质量指数、地区等的关系。结果中国6~18岁儿童和青少年FeNO的几何均值为14.1 ppb,其95%置信区间(偏态分布)为1.0~38.2 ppb。6~11岁儿童的FeNO几何均值为13.1 ppb,其95%置信区间(偏态分布)为1.0~38.1 ppb;12~18岁组的FeNO几何均值为15.7 ppb,其95%置信区间(偏态分布)为2.0~38.2 ppb。11岁及以下儿童FeNO值随年龄减小而降低,每减小1岁,FeNO值降低1 ppb。多元回归分析结果显示,6~11岁儿童年龄与FeNO对数值显著相关(P<0.01);12~18岁组性别、身高、地区与FeNO对数值显著相关(均P<0.01)。结论中国儿童和青少年的FeNO值较此前的中国多中心研究(2010年至2012年)偏高。对12~18岁年龄,推荐采用16 ppb作为临床切点。对11岁及以下儿童,考虑年龄的影响,年龄每减小1岁,FeNO切点值降低1 ppb。

Objective To investigate the normal range of exhaled nitric oxide(FeNO)in 6-18-year-old children in China,so as to provide a data base for the establishment of FeNO standards for Chinese children.Methods A multi-center study was conducted on 5949 children aged 6-18(3101 males and 2848 females)in 16 pro-vinces of 7 administrative districts in China.According to the technical standard recommended by American Thoracic Society/European Respiratory Association,FeNO was measured,and the relationship of FeNO with the sex,age,height,weight,body mass index and region was discussed.Results The geometric mean FeNO value of Chinese children aged 6-18 was 14.1 ppb,and its 95% confidence interval(skewness distribution)was 1.0-38.2 ppb.The geometric mean FeNO values of children aged 6-11 and 12-18 were 13.1 ppb and 15.7 ppb,respectively,and their 95% confidence intervals(skewness distribution)were 1.0-38.1 ppb and 2.0-38.2 ppb.For children at and under 11 years old,FeNO decreased with age,with a mean decline of 1 ppb per year.The multiple linear regression results suggested that there was a significant correlation between FeNO and age for children aged 6-11,and FeNO of children aged 12-18 was significantly correlated with the gender,height,and region(all P<0.01).Conclusions FeNO values of Chinese children and adolescents in this study are higher than those obtained by the previous study conducted from 2010 to 2012.For children aged 12-18,16 ppb is recommended as the clinical cut-off point.For children at or under 11 years old,the influence of age on FeNO should be considered,and the cut-off point of FeNO decreases by 1 ppb as the age is reduced by one year.