喘息婴幼儿潮气肺功能、呼出气一氧化氮及过敏原研究

目的:研究喘息婴幼儿潮气肺功能和呼出气一氧化氮(FeNO)的变化，着重探讨过敏体质在其中的潜在作用。方法:纳入成都市妇女儿童中心医院呼吸科2018年2月至2019年1月收治的急性下呼吸道感染婴幼儿285例，回顾性分析患儿的一般资料，喘息的危险因素，喘息与潮气肺功能及FeNO的关系，并通过亚组分析探究过敏因素在其中的作用...

Study on tidal breathing lung function,fractional exhaled nitric oxide and allergens in wheezing infants

Objective To explore the variation of tidal breathing lung function and fractional exhaled nitric oxide(FeNO)on wheezing infants,especially when taking the role of atopy into consideration.Methods A total of 285 inpatient infants who were diagnosed with acute lower respiratory tract infections from February 2018 to January 2019 were enrolled in Chengdu Women′s&Children′s Central Hospital.And a retrospective analysis of the general data of the cases,the risk factors of wheeze,and the relationships between wheeze and lung function/FeNO were conducted.In addition,subgroup analysis was used to explore the potential effects of atopy in the relationships.Results Logistic regression analysis revealed that male(χ²=13.071,P<0.001)and atopy(χ²=8.889,P=0.003)were the main risk factors affecting wheeze.Among the total cases included,infants with wheeze had lower time to peak tidal expiratory flow as a proportion of expiratory time(TPTEF/TE)and lower volume to peak expiratory flow as a proportion of exhaled volume(VPEF/VE),but higher FeNO than that of infants without wheeze(all P<0.05).As for infants with wheeze,atopy didn′t affect tidal breathing lung function parameters,but it was related to FeNO increase(P<0.05).Subgroup analysis of atopy revealed that infants with wheeze had lower TPTEF/TE and VPEF/VE(both P<0.05)than that of infants without wheeze,but there was no difference in FeNO(Z=-1.264,P>0.05)among non atopic patients.According to allergen categories,it was found that FeNO was higher in the infants with inhaled and mixed allergens positive than that of those with allergens negative(P<0.05),but there was no difference in tidal breathing lung function between the groups(P>0.05).Conclusions As for infants with wheeze,the tidal breathing lung function reduces,while FeNO increases.The influence of wheeze on lung function does not depend on atopy.However,the effect of wheeze on FeNO is related to inhaled allergen spositive.Further investigation to the effects of subgroup inhaled allergens on wheeze and FeNO may provide a theoretical foundation for accurate clinical treatment.