呼出气一氧化氮在儿童哮喘管理中的作用  

Application of Fractional Exhaled Nitric Oxide in Management of Childhood Asthma

作　　者：顾剑华[1] 金晓群[1] 徐艳娜[1] 桂丽琼[1] 李永莲[1] 金殊 

机构地区：[1]上海市普陀区人民医院儿科,上海200060

出　　处：《实用临床医学（江西）》2015年第4期56-59,共4页Practical Clinical Medicine

基　　金：2012年上海市普陀区卫生系统自主创新项目(普KW12303)

摘　　要：目的探讨哮喘患儿呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)在儿童哮喘管理中的作用。方法选取未规范治疗的哮喘患儿60例(哮喘组)和同期40例健康儿童(对照组)。哮喘组患儿给予6个月的沙美特罗氟替卡松气雾剂(Shah Mette Lo fluticasone propionate aerosol,商品名:舒利迭,50μg/100μg,bid)治疗,检测治疗前及治疗后6个月的FeNO、血清嗜酸阳离子蛋白(eosinophile cationic protein,ECP)、血清总免疫球蛋白E(total serum immunoglobulin E,IgE)及肺功能指标FEVl占预计值百分比(FEVl%)。结果治疗前,哮喘组FeNO、ECP及IgE均明显高于对照组(均P<0.01),FEVl%明显低于对照组(P<0.01)。与治疗前比较:哮喘组治疗6个月后的FeNO、ECP及IgE显著降低(均P<0.01),但仍高于对照组(均P<0.01);FEVl%水平明显升高(P<0.01),但与对照组比较差异无统计学意义(P>0.05)。治疗前哮喘组FeNO与血清ECP、IgE呈正相关(r=0.850,P=0.000;r=0.689,P=0.000),与FEVl%无相关性(r=-0.216,P=0.097)。治疗6个月后,FeNO仍与血清ECP呈正相关(r=0.665,P=0.000),而与FEVl%、IgE无相关性(r=0.185,r=0.226;P>0.05)。结论FeNO是一种较理想的反映气道嗜酸性炎症的生物学指标,有助于评估哮喘的控制情况。ABSTRACT:Objective To discuss the application of fractional exhaled nitric oxide(FeNO)in the management of childhood asthma.Methods Sixty asthmatic children without standard medication treat-ment were treated with Shah Mette Lo fluticasone propionate aerosol(Seretide,50μg/100μg,bid).In addition,40 healthy children were recruited as controls.The FeNO,serum eosinophil cationic pro-tein(ECP),total serum immunoglobulin E(IgE)and forced expiratory volume in one second(FE-Vl)percent predicted (FEVl%)were determined before and after treatment for 6 months.Results Compared with control group,levels of FeNO,ECP and IgE increased before and after treat-ment but FEVl% decreased before treatment in asthmatic group(P<0.01).After treatment for 6 months,levels of FeNO,ECP and IgE decreased but FEVl% increased in asthmatic group (P<0.01).There was no significant difference in FEVl% between the two groups after treatment (P>0.05).Before treatment,FeNO levels were positively correlated with ECP levels(r=0.850, P=0.000)and IgE levels(r=0.689,P=0.000),but were not correlated with FEVl%(r=-0.216,P=0.097)in children with asthma.After treatment for 6 months,FeNO levels were still positively correlated with ECP levels(r=0.665,P=0.000),but were not correlated with FE-Vl%、IgE(r=0.185,r=0.266;P<0.05)in children with asthma.Conclusion FeNO is an ideal biological indicator reflecting eosinophilic airway inflammation,which can help to assess the con-trol of asthma.

关 键 词：呼出气一氧化氮 哮喘 哮喘管理 儿童 

分 类 号：R725.6[医药卫生—儿科]