| 摘要: |
| ［摘要］ 目的 通过监测哮喘儿童急性发作期与慢性持续期呼出气一氧化氮（fractional exhaled nitric oxide，FeNO）水平变化，了解其在儿童哮喘病情严重程度评估及治疗过程中的指导作用，探讨儿童哮喘在疾病不同时期FeNO水平与气道炎症之间的关联性。方法 选取87例儿科门诊的5～12岁哮喘儿童，其中轻度哮喘组45例（男性28例，女性17例）；中-重度哮喘组42例（男性25例，女性17例）。使用无锡尚沃生物科技有限公司生产的SV-eNO-01纳库仑一氧化氮检测器，Sunvou-D100纳库仑呼气分析仪，分别于急性发作期及经治疗4周后的哮喘儿童进行FeNO水平检测，同步完成哮喘控制测试（ACT）评分。结果 （1）哮喘儿童治疗前FeNO平均水平为(43.52±27.52)ppb，明显高于治疗后的(19.33±13.98)ppb和健康对照组的(7.89±3.06)ppb，差异有统计学意义（P均<0.01）。治疗4周后哮喘儿童的FeNO平均水平仍高于健康对照组，两组比较差异有统计学意义（P<0.01）。（2）轻度哮喘组治疗前FeNO平均水平为(28.49±14.99)ppb，高于健康对照组（P<0.01）；中-重度哮喘组治疗前FeNO平均水平为(59.97±29.37)ppb，明显高于轻度哮喘组和健康对照组，差异有统计学意义（P均<0.01）。（3）治疗后，轻度哮喘组FeNO平均水平为(13.77±7.19)ppb，与健康对照组比较差异无统计学意义（P>0.05）。而中-重度哮喘组治疗后FeNO平均水平为(27.84±16.98)ppb，虽然下降但仍高于健康对照组(P<0.01）。（4）哮喘儿童FeNO平均水平变化与ACT评分呈负相关性，r急性发作期=-0.706，r慢性持续期=-0.566，P均=0.000。结论 儿童哮喘急性发作期FeNO水平增高，以中-重度急性发作尤其明显，哮喘规范治疗后FeNO水平下降，其对哮喘临床诊断和治疗方案制定有实用意义。 |
| 关键词: 呼出气一氧化氮 哮喘 诊断 治疗 儿童 |
| DOI：10.3969/j.issn.1674-3806.2016.09.08 |
| 分类号:R 725.6 |
| 基金项目:广西医疗卫生适宜技术研究与开发课题（编号：S201315-06）；广西卫计委科研课题（编号：Z2013330） |
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| Clinical practice of the parameters of fractional exhaled nitric oxide in asthmatic children |
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XIE Qing-ling, ZHANG Di-wen, WANG Mei-chun, et al.
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Department of Pediatrics, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021,China
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| Abstract: |
| ［Abstract］ Objective To investigate the guiding role on the assessment of asthmatic status and the guidance of treatment by measuring the fractional exhaled nitric oxide(FeNO) levels in children with asthma.Methods A total of 87 asthmatic children aged 5～12 years from pediatric outpatient were studied, including 45 cases of mild asthmatic exacerbation group and 42 cases of moderate-severe exacerbation group. The FeNO levels of the children with asthma were measured by using SV-eNO-01 Nano Coulomb Nitric Oxide Detector and Sunvou-D100 Nano Coulomb expiration Analyzer respectively in acute asthmatic exacerbation and after the treatment for four weeks, and the questionnaire of asthma control test(ACT) was completed at the same time.Results （1）The FeNO levels of asthmatic children (43.52±27.52)ppb were significantly higher before the treatment than those after the treatment (19.33±13.98)ppb and those of the control group (7.89±3.06)ppb (P<0.01). The levels of FeNO of asthmatic children after four weeks′ treatment were still significantly higher than those of the control group(P<0.01).（2）The levels of FeNO in the mild asthmatic exacerbation group (28.49±14.99)ppb were significantly higher than those in the control group before the treatment(P<0.01), and the levels of FeNO in the moderate-severe exacerbation group (59.97±29.37)ppb were significantly higher than those in the mild exacerbation group and the control group before the treatment(P<0.01).（3）There were no significant differences in FeNO levels between the mild asthmatic exacerbation group (13.77±7.19)ppb and the control group after the treatment(P>0.05), however, the FeNO levels in the moderate-severe exacerbation group (27.84±16.98)ppb were significantly lower than those before the treatment but significantly higher than those in the control group(P<0.01).(4)The variation of FeNO levels in the asthmatic children was positively correlated with ACT scores before(r=-0.706) and after the treatment(r=-0.566), P=0.000.Conclusion FeNO levels are strongly related to the clinical features of childhood asthma. FeNO levels increase with the exacerbation of asthma and decrease after the standardized treatment. |
| Key words: Fractional exhaled nitric oxide Asthma Diagnosis Treatment Children |
