哮喘患儿呼出气一氧化氮及外周血嗜酸粒细胞的变化

目的：检测支气管哮喘（AS），AS合并过敏性鼻炎（AS/AR）及慢性咳嗽变异性哮喘（CVA）患儿中呼出气一氧化氮（eNO）和外周血嗜酸粒细胞（EOS）的水平及两者的相关性，以探讨eNOS检测在AS儿童中的应用。方法：采用电化学法对5～14岁患有AS（n=12）、AS/AR（n=29）、CVA（n=10）的患儿进行eNO测定，同时测定EOS及一秒钟用力呼气容积占预计值百分比（FEV1％）。30例无特异性疾病史和家族过敏史，且近两周无急性呼吸道感染史的儿童作为对照组。结果：AS，AS/AR，CVA 3组eNO和EOS水平均高于对照组（P＜0.01）；AS/AR组eNO（50.3±6.7 ppb）和EOS水平（5.9±4.2×109）高于AS组（30.5±8.8 ppb，4.2±3.2×109）及CVA组（26.0±3.2 ppb，3.7±6.9×109）（均P＜0.05），而AS、CVA组间差异无显著性；AS组eNO与EOS呈正相关（r＝0.51，P＜0.05），但与FEV1无相关性（r＝0.144，P＞0.05）。结论：eNO在过敏性体质中高表达，且eNO可以反映AS患者气道嗜酸性炎症水平。［中国当代儿科杂志，2009，11（12）：986-988］

Changes of exhaled nitric oxide and peripheral blood eosinophils in children with asthma

Objective This study examined the levels of exhaled nitric oxide ( eNO) and peripheral blood eosinophils (EOS) as well as the correlation between the two markers in children with bronchial asthma (AS) ,AS complicated by allergic rhinitis (AS/AR) and chronic cough variant asthma (CVA) , in order to explore the value of eNOS detection in children with AS. Methods The eNO level was measured using light-emitting electrochemical photometry in 12 children with AS, 29 children with AS/AR and 10 children with CVA. Peripheral blood EOS was counted by blood cell counter (Coulter JT). Forced expiratory volume in one second ( FEV1 ) was assessed by lung function measurement. Thirty children without atopic disease and acute respiratory infection as well as without a family history of atopic diseasea served as the control group. Results The levels of eNO and blood EOS in the AS, the AS/AR and the CVA groups were significantly higher than those in the control group ( P < 0.01). The AS/AR group showed increased levels of eNO (50.3 ±6.7 ppb) and EOS (5.9 ±4.2 × 10~9) compared with the AS (30.5 ±8. 8 ppb and 4.2 ±3.2 × 10~9 respectively)and the CVA groups (26.0 ±3.2 ppb and 3.7 ±6.9 × 10~9 respectively) (P<0.05). There were no significant differences in eNO and EOS levels between the AS and the CVA groups. The eNO level was positively correlated with the EOS level (r=0.51, P<0.05), but not with FEV1 (r=0.144, P > 0. 05) in the AS group. Conclusions eNO is highly expressed in children with symptoms of atopy and can reflect the levels of eosinophilic airway inflammation in children with AS.