呼出气一氧化氮监测在儿童哮喘吸入性糖皮质激素治疗中的应用

Application of exhaled nitric oxide monitoring in the treatment of inhaled corticosteroids in children with asthma

目的探究呼出气一氧化氮(FeNO)含量监测在儿童哮喘吸入性糖皮质激素(ICS)治疗中的应用价值。方法选取2017年3月-2019年4月永康市妇幼保健院收治的84例行ICS治疗的儿童哮喘患儿为研究对象,根据随机数字表法分为观察组和对照组,每组各42例。对照组患儿根据哮喘控制水平分级进行临床治疗方案的调整,观察组患儿在对照组基础上结合FeNO检测结果进行调整。治疗6个月后,比较两组患儿的临床疗效。结果治疗前,两组患儿FeNO水平比较,差异无统计学意义(P>0.05)。治疗后,两组患儿FeNO水平均有所下降,且观察组下降幅度及随访6个月后水平均优于对照组,差异均有统计学意义(均P<0.05)。治疗前,两组患儿C-ACT水平比较,差异均无统计学意义(均P>0.05)。治疗后,两组患儿C-ACT水平均有所提高,且观察组改善程度明显优于对照组,差异均有统计学意义(均P<0.05)。治疗前,两组患儿FEV_1及MEF50占预计值比例比较,差异均无统计学意义(均P>0.05)。治疗后,两组患儿FEV_(1)及MEF_(50)占预计值比例均有所改善,且观察组明显优于对照组,差异均有统计学意义(均P<0.05)。两组患儿治疗期间平均急性发作次数及短效β2受体激动剂使用时间比较,差异均无统计学意义(均P>0.05);观察组患儿平均ICS使用剂量高于对照组,差异有统计学意义(P<0.05)。结论在儿童哮喘ICS治疗中应用FeNO含量监测能够提高患儿临床治疗效果,改善肺功能,值得推广。

Objective To explore the value of monitoring exhaled nitric oxide(FeNO)in the treatment of inhaled glucocorticoids(ICS)in childhood asthma.Methods A total of 80 children with asthma who received ICS treatment in Yongkang Maternal and Child Health Hospital from March 2017 to April 2019 were selected as the research objects,and were divided into observation group and control group according to the random number table method,with 42 patients in each group.The children in the control group were adjusted according to the level of asthma control,and the children in the observation group were adjusted based on the control group and the FeNO test results.After 6 months of treatment,the clinical efficacy of the two groups was compared.Results Before treatment,there was no statistically significant difference in FeNO level between the two groups(P>0.05).After treatment,FeNO level of children in both groups decreased,and the extent of decrease in the observation group and the level after 6 months of follow-up were better than that in the control group,with statistically significant differences(P<0.05).Before treatment,c-ACT levels of the two groups were compared,and the difference was no statistically significant difference(P>0.05).After treatment,the c-ACT level of children in both groups was improved,and the improvement level of the observation group was significantly better than that of the control group,with statistically significant differences(P<0.05).Before treatment,the proportion of FEV_(1)and MEF_(50)in the predicted value was compared between the two groups,and the difference was no no statistically significant difference(P>0.05).After treatment,the proportion of FEV1 and MEF50 in the predicted value in the two groups was improved,and the observation group was significantly better than the control group,with statistically significant differences(P<0.05).The comparison of the average number of acute attacks and the short duration of use ofβ2 receptor agonists during treatment between the two groups showed no statistically significant difference(P>0.05);The average ICS dose in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion FeNO content monitoring in ICS treatment of children with asthma can improve the clinical therapeutic effect of children and improve lung function,which is worthy of promotion.