【作者】 刘传合； 邵明军； 沙莉； 李硕； 罗雁青； 宋欣； 李志英； 陈育智；

【Author】 Chuanhe Liu;Mingjun Shao;Li Sha;Shuo Li;Yanqing Luo;Xin Song;Zhiying Li;Yuzhi Chen;Capital Institute of Pediatrics;

【机构】 首都儿科研究所哮喘防治与教育中心；

【摘要】 目的探讨呼出气一氧化氮(exhaled nitric oxide,eNO)水平在社区儿童的改变及对哮喘诊断与管理的价值。方法对来自社区的7-12岁的133名非哮喘儿童和94例哮喘儿童同时进行了呼出气一氧化氮的测定,肺功能检测,过敏原皮肤点刺检查(skin prick test,SPT)以及询问病史和常规体检,观察呼出气一氧化氮在社区非哮喘儿童和哮喘儿童的改变,影响因素及与临床情况的相关性。结果非哮喘儿童与哮喘儿童呼出气一氧化氮的水平分别为11.63±1.88ppb,19.68±2.31 ppb,其差异有统计学意义(p<0.01)。在非哮喘儿童中,有鼻炎儿童的eNO水平(17.5±2.0ppb)显著高于无鼻炎儿童(10.42±1.76ppb),特应性儿童的eNO水平(16.12±1.98ppb)显著高于非特应性儿童(9.60±1.66ppb),其差异均有统计学意义(p分别<0.05,0.01)。在哮喘儿童中,伴有鼻炎与不伴有鼻炎儿童,其eNO水平分别为19.54±2.31ppb;20.09±2.25ppb,其差异无统计学意义;但特应性儿童eNO水平(23.06±2.18ppb)显著高于非特应性儿童(8.75±1.86ppb,p<0.01);哮喘未控制儿童eNO(25.09±2.31 ppb)显著高于哮喘控制儿童(17.21±2.22ppb,p<0.05);曾使用过吸入激素与未曾使用吸入激素儿童,其eNO水平未见显著差别。无论是非哮喘儿童,还是哮喘儿童,其eNO水平与肺功能各参数间均无相关性。结论呼出气一氧化氮水平在社区特应性哮喘儿童中显著升高,并与哮喘控制与否有关。特应性是影响eNO水平的突出因素。在社区儿童中测定一氧化氮有利于对儿童哮喘的进行早期诊断和分型,全面了解其过敏情况,从而改善哮喘的管理。更多还原

【Abstract】 Objective:To explore the change of exhaled nitric oxide(eNO) in children from community and its importance in asthma management.Methods:133 non-asthmatic children and 94 asthmatic children aged 7-12 years old from community were included in the study.eNO,skin prick test(SPT),lung function,physical examination were carried out and information of medical history were collected in all children.eNO level between non-asthmatic children and asthmatic children,and its association with atopy,rhinitis,lung function and clinical points were analyzed.Results:eNO levels of non-asthmatic children and asthmatic children were 11.63±1.88 ppb,and 19.68±2.31 ppb respectively and the difference between was statistically significant(p<0.01).In non-asthmatic children,the level of eNO in children with rhinitis was significantly higher than in children without rhinitis(17.5±2.0ppb vs.10.42±1.76 ppb,p<0.05) and eNO level in atopic children is higher than non-atopic children(23.06±2.18 ppb vs.9.60±1.66 ppb,p<0.01).In asthmatic children,the difference in eNO level was not significant in children with rhinitis and without rhinitis(19.54±2.31ppb;20.09±2.25ppb),but the eNO levels in atopic children(23.06±2.18ppb) was significantly higher than non-atopic children(8.75±1.86 ppb,p<0.01).The level of eNO of uncontrolled asthmatic children was significantly higher than controlled asthmatic children(25.09±2.31 ppb vs.17.21±2.22 ppb,p<0.05).There is no significant difference in eNO level between children who used and did not used inhaled corticosteroid.The eNO level was not related to lung function parameters either in non-asthmatic or asthmatic children.Results:eNO level increased significantly in children with asthma or rhinitis and associated with asthma control status.Atopy was an important factor on eNO level as well.Measuring eNO level would help improve the diagnosis of asthma and atopy and management of asthma and rhinitis in children from community.更多还原