呼出气一氧化氮浓度与儿童哮喘病情控制及不同哮喘亚型的相关性研究

目的:探讨呼出气一氧化氮(FeNO)浓度与儿童哮喘病情控制及不同哮喘亚型的相关性。方法:选取2017年1月至2018年1月期间于我院确诊为支气管哮喘及毛细支气管炎的患儿各60例,分别设为哮喘组与毛细支气管炎组,另选取同期于我院进行体检的健康儿童40例作为对照组。哮喘组与毛细支气管炎组分别在治疗前、治疗后1 h及治疗后4周测定FeNO,对照组在体检时测定FeNO。对比对照组体检时以及哮喘组、毛细支气管炎组患儿不同治疗时期的FeNO浓度变化;哮喘组患儿根据不同病情控制情况分为哮喘控制组、哮喘部分控制组与哮喘未控制组,根据不同哮喘亚型分为咳嗽变异性组与非咳嗽变异性组,分析FeNO与哮喘患儿疾病控制情况、哮喘亚型的相关性。结果:哮喘组治疗前的FeNO浓度高于毛细支气管炎组治疗前和对照组体检时的FeNO浓度(P0.05);与治疗前与治疗后1 h比较,治疗4周后哮喘组与毛细支气管炎组患儿FeNO浓度降低(P0.05),治疗后1 h及治疗4周后哮喘组FeNO浓度高于毛细支气管炎组(P0.05)。哮喘控制组FeNO浓度低于部分控制组与哮喘未控制组,哮喘部分控制组FeNO浓度低于哮喘未控制组,咳嗽变异性组FeNO浓度高于非咳嗽变异性组(P0.05)。FeNO浓度与病情控制呈负相关,FeNO浓度越低,病情控制程度越好(r=-0.512,P=0.034)。结论:哮喘患儿的FeNO浓度高于毛细支气管炎患儿、健康儿童,且与患儿哮喘的病情控制存在相关性,可作为哮喘患儿的辅助诊断指标。

Study on the Relationship between Fractional Exhaled Nitric Oxide, Asthma Control in Children and Different Subtypes of Asthma

ABSTRACT Objective: To investigate the correlation between fractional exhaled nitric oxide (FeNO), asthma control in children and different subtypes of asthma. Methods: 60 children with bronchial asthma and bronchiolitis who were diagnosed in our hospital from January 2017 to January 2018 were selected. They were divided to asthma group and bronchiolitis group. In addition, 40 healthy children who underwent physical examination for non-respiratory diseases in the same period in our hospital were selected as the control group. The FeNO of asthma group and bronchiolitis group were measured before treatment, 1 h after treatment and 4 weeks after treatment. FeNO was measured in the control group at the time of physical examination. The changes of FeNO concentration in control group at the time of physical examination, asthma group and bronchiolitis group at different stages of treatment were compared. children in the asthma group were divide into the asthma controlled group, asthma part controlled group and asthma uncontrolled group according to their asthma control status, and divided into cough variant group and non-cough variant group according to their asthma subtypes. The correlation between FeNO, asthma control and asthma subtypes in children with asthma were analyzed. Results: The concentration of FeNO in asthma group before treatment was higher than that in bronchiolitis group before treatment and control group at the time of physical examination(P<0.05). Compared with before and 1 h after treatment, the concentration of FeNO in asthmatic group and bronchiolitis group decreased significantly at 4 weeks after treatment(P<0.05). The concentration of FeNO in asthma group was higher than that in bronchiolitis group 1 h after treatment and 4 weeks after treatment (P<0.05). The concentration of FeNO in asthma controlled group were significantly lower than asthma part controlled group and asthma uncontrolled group. The concentration of FeNO in asthma part controlled group was lower than that in asthma uncontrolled group. The concentration of FeNO in cough variance group was higher than that in non-cough variance group(P<0.05). The concentration of FeNO was negatively correlated with disease control, the lower the concentration of FeNO, the better the disease controlled (r=-0.512, P=0.034). Conclusion: The concentration of FeNO in children with asthmatic was significantly higher than that in children with bronchiolitis and healthy children. It has correlation with asthma control, and can be used as an auxiliary diagnostic index for children with asthma.