目的 评估呼气中一氧化氮(FeNO)监测在儿童哮喘的价值, 为更好控制和监测哮喘病情提供帮助。方法 随机选取就诊于福州儿童医院变态反应科的轻、中、重度哮喘儿童50例为实验组, 分别在治疗3个月和治疗6个月进行随访、评估病情。随访时记录日、夜间哮喘症状评分、FeNO和肺功能。同期随机选择50例健康对照组给予检测FeNO。结果 1)实验组治疗3个月FeNO值较治疗前显著降低, 差异有统计学意义(P＜0.000 1), 与治疗6个月比较, 差异无统计学意义(P＞0.05)。2)实验组FeNO值和日、夜间哮喘症状评分在治疗3个月、治疗6个月呈明显下降;肺功能各参数FEV1%、FVC和PEF值在治疗3个月、治疗6个月呈明显升高, 差异有统计学意义(P＜0.05)。3)实验组治疗前、后FeNO值明显高于健康对照组(P＜0.000 1)。结论 FeNO可以作为一项很好的指标来评估哮喘患儿的气道炎症。
Abstract
Objective To assess the value of fractional exhaled nitric oxide (FeNO) monitor in the control of children with asthma. Methods A total of 50 children with light, moderate and severe asthma from department of allergy were selected into the experimental group.FeNO concentrations, pulmonary function test, the score of the day night time asthma symptom were detected and analyzed before and after treatment of 3 months and 6 months .At the same period, 50 cases of healthy control group were detected FeNO. Results 1)Compared with no treatment, FeNO value decreased significantly after 3 months treatment, the difference was statistically significant (P<0.000 1), but there was no statistically significant difference between the 3 months and 6 months treatment (P>0.05) in the experimental group.2)FeNO concentrations and the score of symptom in the day night time asthma were all decreased significantly for 3 months and 6 months treatment in the experimental group.The FEV1% , the FVC, the PEF value of lung function were all increased significantly for 3 months and 6 months treatment in the experimental group(P＜0.05).3)The FeNO value before and after treatment in the experimental group were significantly higher than that in the control group (P<0.000 1). Conclusion FeNO concentrations can evaluate airway inflammation in children with asthma as a good indicator.
关键词
哮喘 /
呼气中一氧化氮 /
儿童
Key words
asthma /
fractional exhaled nitric oxide /
children
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参考文献
[1] Pijncnburg MW, De Jongste JC.Exhaled nitric oxide in childhood asthma:a review[J].Clinical and Experimental Allergy, 2008, 38(2):246-259.
[2] 中华医学会儿科分会呼吸学组, 《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南[J].中华儿科杂志, 2008, 46(10):745-753.
[3] American Thoracic Society, European respirtory Society.ATS/ERS recommendation for standardized procedures for the on-1ine and off-line measure of exhaled lower respiratory nitric oxide and nasal nitric oxide in adults and children-2005[J].Am J Respir Crit Care Med, 2005, 171(8):912-930.
[4] Strunk RC, Szefler SJ, Phillips BR, et al.Relationshipof exhaled nitric oxide to clinical and inflammatory markers of persistent asthma in children[J].Allergy Clin Immunol, 2003, 112(5):883-892.
[5] Malmberg LP, Pelkonen AS, Haahtela T, el al.Exhaled nitric oxide rather than lung function distinguishes perschool children with prohable asthma[J].Thorax, 2003, 58(6):494-499.
[6] 向莉, 付亚南, 李珍.不同控制水平的哮喘患儿呼出气一氧化氮浓度水平及其临床意义[J].中国当代儿科杂志, 2013, 15(1):29-32.
[7] Beck-Ripp J, Griese M , Arenz S, et al.Changes of exhaled nitric oxide during steroid treatment of childhood asthma[J].Eur Respir J, 2002, 19(6):1015-1019.
[8] Paro-Heitor ML, Bussamra MH, Saraiva-Romanholo BM, et al.Exhaled nitric oxide for monitoring childhood asthma inflammation cocmpared to sputum analysis serum interleukins and pulmonary function[J].Pediatr Pulmonol, 2008, 43(2):134-141.
[9] Szefler SJ, Mitchell H, Sorkness CA, et al.Management of asthma based on exhaled nitric oxide in addition to guideline-based treatment for inner-city adolescents and young adults:a randomised controlled trial[J].Lancet, 2008, 372(9643):1065-1072.
基金
福建省自然科学基金计划项目(2009J01322)
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