口鼻呼出气一氧化氮评估儿童腺样体切除术治疗的初步临床观察

Preliminary clinical observation of the influence of adenoidectomy on nasal nitric oxide and fractional exhaled nitric oxide in children

目的探讨儿童腺样体切除术对口呼出气一氧化氮(FeNO)、鼻呼出气一氧化氮(nNO)的影响及临床意义。方法2015年1月~2016年7月广州市妇女儿童医疗中心耳鼻咽喉头颈外科招募腺样体肥大的5~14岁患儿,共26例纳入试验组。腺样体切除术前和术后2周、术后2个月分别测量FeNO和nNO浓度。评估腺样体切除术对FeNO和nNO的影响及临床意义。选择同期就诊健康儿童共10例,纳入对照组。结果试验组术前nNO浓度为128.0[55.0;368.0]10^(-9)(中位数[25分位数;75分位数]),比对照组的650.0[505.5;765.8]10^(-9)低,差异有统计学意义(P<0.05);术后2个月nNO浓度(560.5[326.0;878.8]10^(-9))与术前(128.0[55.0;368.0]10^(-9))、术后2周(86.5[48.5;258.3]10^(-9))相比均升高,差异有统计学意义;术后2个月FeNO浓度(17.0[16.0;21.0]10^(-9))与术前(12.5[9.8;16.7]10^(-9))、术后2周(15.0[12.0;17.3]10^(-9))相比均升高,差异具有统计学意义(P<0.05)。余差异均无统计学意义。结论腺样体切除术2个月后,FeNO和nNO浓度升高,甚至达到正常值水平,有利于上呼吸道本身的预防作用及纤毛功能的改善,可能降低鼻部其他疾病发病率。

Objective To evaluate the influence of adenoidectomy on fractional exhaled(FeNO)and nasal nitric oxide(nNO)and its clinical significance.Methods Twenty-six children aged from 5 to 14 years were diagnosed as adenoid hypertrophy in the Department of Otolaryngology of Guangzhou Women and Children’s Medical Center between January 2015 and July 2016 and were enrolled as the experimental group respectively.The FeNO and nNO levels were measured before and 2 weeks and 2 months after adenoidectomy.The changes in the concentration of FeNO and nNO before and at 2 weeks and 2 months following adenoidectomy were calculated.Ten healthy children simultaneously were assigned to the control group.Results Compared with the control group(650.0[505.5;765.8]ppb),pre-operative nNO concentration in the experimental group(128.0[55.0;368.0]10^(-9))was significantly decreased(P<0.05).In the experimental group,the concentrations of nNO(560.5[326.0;878.8]10^(-9))and FeNO(17.0[16.0;21.0]10^(-9))was significantly elevated 2 months post-operatively compared with the pre-operative(nNO:128.0[55.0;368.0]10^(-9);FeNO:12.5[9.8;16.7]10^(-9))and 2-week post-operative(nNO:86.5[48.5;258.3]10^(-9);FeNO:15.0[112.0;17.3]10^(-9))concentrations(P<0.05).Conclusions The concentration of nNO and FeNO was enhanced 2 months postoperatively compared with pre-operatively and 2 weeks post-operatively,suggesting that host defense in the upper and lower airways was potentiated and airway inflammation was improved.