新生儿呼吸道疾病呼出气一氧化氮水平及其临床意义

Clinical Significance of Levels of Fractional Exhaled Nitric Oxide in Neonatal Respiratory Diseases

目的:通过研究新生儿呼吸道疾病呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)水平及其临床意义,希望寻找一种简单、容易操作、可重复及无创的气道炎症检测手段来满足临床需要。方法:对2018年8月至2022年8月在我院住院的患呼吸道疾病早产儿、患新生儿肺炎足月儿以及正常新生儿的FeNO水平及血常规中各血细胞值等情况进行分析,并对部分患儿进行了FeNO水平的随访。结果:正常新生儿FeNO水平与外周血嗜酸性粒细胞百分比及计数均呈正相关关系(EOS%r=0.597,P=0.005;EOS计数r=0.478,P=0.033),其正常参考值为小于9.534ppb;足月患儿组FeNO水平明显高于早产患儿组及正常新生儿组,随访的足月患儿组FeNO水平明显下降(P值均<0.05)。结论:患新生儿肺炎足月儿肺部炎症与嗜酸性粒细胞气道炎症反应密切相关,而患呼吸道疾病早产儿无明显关联。

Objective:To investigate the level of fractional exhaled nitric oxide(FeNO)and its clinical signifi⁃cance in neonatal respiratory diseases,so as to find a simple,easy,repeatable and noninvasive detection method of air⁃way inflammation to meet the clinical needs.Methods:The FeNO levels and the blood cell values in the blood routine were analyzed for premature infants with respiratory disease,term infants with neonatal pneumonia and normal neonates who were hospitalized in our hospital from August 2018 to August 2022,and some patients were followed up for FeNO levels.Results:The FeNO level in normal neonates was positively correlated with the percentage and count of eosino⁃phils in peripheral blood(EOS%r=0.597,P=0.005;EOS count r=0.478,P=0.033),and the normal reference value was less than 9.534ppb.The FeNO level in the full⁃term infant group was significantly higher than that in the preterm in⁃fant group and the normal neonatal group,and the FeNO level in the term infant group was significantly decreased dur⁃ing follow⁃up period(P<0.05).Conclusion:Pulmonary inflammation was closely related to eosinophilic airway inflam⁃mation in term infants with neonatal pneumonia,but not in preterm infants with respiratory disease.