学龄前儿童呼出一氧化氮及气道高反应性与哮喘控制的相关性研究

目的 探讨学龄前哮喘儿童不同控制阶段气道高反应性指标(脉冲震荡肺功能检测指标)、呼出一氧化氮(FeNO)与哮喘控制的相关性.方法 选取2015年4月至2017年2月该院儿科门诊确诊的哮喘儿童74例,体检检查肺功能及FeNO的儿童25例作为对照,年龄3～5岁,根据2016年版儿童支气管哮喘防治指南标准分为3组:控制组(n=26)、非控制组(n=48)及对照组(n=25),收集所有入组患儿FeNO及脉冲震荡肺功能检测指标呼吸道总阻力(R5)、中心呼吸道阻力(R20)、周边呼吸道阻力(R5-20)、电抗面积(AX)、周边弹性阻力(X5)、响应频率(Fres)等数据,分析3组间FeNO、脉冲震荡肺功能检测值及其相关性.结果 (1)非控制组FeNO检测值(34.00±18.17)明显高于控制组(20.23±11.07)及对照组(28.00±17.30)(P＜0.05).非控制组AX检测值(37.29±15.27)明显高于控制组(30.17±9.50)(P＜0.05).(2)控制组R20与FeNO呈弱负相关(P＜0.05),非控制组、对照组R20与FeNO无相关性(P＞0.05).非控制组、控制组及对照组FeNO与R5、R5-20、AX、X5、Fres均无明显相关性(P＞0.05).结论 学龄前哮喘儿童FeNO可反映气道嗜酸性粒细胞炎症控制,不能反映气道高反应性;FeNO与脉冲振荡肺功能指标(气道高反应性指标AX等)联合使用更能精确判断哮喘是否控制.

Study on correlation between FeNO,bronchial hyperresponsiveness and asthma control in preschool children

Objective To find out the association between the indicators(pulse concussion lung function test index) of bronchial hyperresponsiveness (BHR) with fractional concentration of exhaled nitric oxide (FeNO) at different control periods among preschool asthmatic children.Methods Totally 74 asthmatic children in the pediatric department of our hospital from April 2015 to February 2017 were enrolled in this study,and 25 children undergoing the lung function and FeNO examination served as the controls,aged 3-5 years old.The cases were divided into three groups according to the standard in 2016 version of the Prevention and Treament Guide of Children Bronchial Asthma:asthma control group(n =26),asthma non-control;group(n =48) and control group (n=25).All data of FeNO,resistance of the respiratory system at 5 Hz(R5),resistance of the respiratory system at 5 Hz (R20),difference of R5 and R20(R5-20),reactance area (AX),reactance of the respiratory system at 5 Hz (X5) and resonant frequency of reactance (Fres) were collected.The FeNO,pulse concussion lung function test value and their association were analyzed.Results (1) The FeNO value of asthma the non-control group was significantly higher than that of the asthma control group and the control group,which were 34.00 ± 18.17,20.23± 11.07 and 28.00± 17.30 respectively.The AX detection value of the asthma non-control group was significantly higher than that of the control group(37.29 ± 15.27 vs.30.17 ± 9.50,P＜0.05).(2)R20 had weak correlation with FeNO in the control group(P＜0.05),while R20 had no correlation with FeNO in the non-control group and control group (P＞0.05).FeNO had no obvious correlation with R5,R520,AX,X5 and Fres in the asthma non-control group,asthma control group and control group(P＞0.05).Conclusion In preschool children with asthma,FeNO can reflect the airway eosinophilic inflammation control,and does not reflect the airway hyperresponsiveness.Thereforeit ie needed to combined with FeNO and IOS indicators (airway hyperresponsiveness index AX,etc.),which can more precisely judge whether asthma being controlled.