肺功能检查与FeNO检测在儿童支气管哮喘规范化管理中的应用  

Application of lung function and FeNO in standardized management of asthmatic children

作　　者：杨蓉[1] 谷丽[1] 崔赛男[1] 李呈媚[1] 何凡[1] 

机构地区：[1]同济大学附属第十人民医院儿科,上海200072

出　　处：《同济大学学报（医学版）》2015年第3期83-86,共4页Journal of Tongji University(Medical Science)

摘　　要：目的评估肺功能检查与呼出气一氧化氮(fractional exhaled nitric oxide,Fe NO)检测在儿童支气管哮喘规范化管理中的作用。方法选取同济大学附属第十人民医院儿科哮喘门诊中未经规范化治疗的哮喘患儿68例,按全球哮喘防治创意(global initiative for asthma,GINA)方案给予规范化管理及治疗并于初始、3个月、6个月、12个月定期检测患儿肺功能及呼出气Fe NO水平。结果轻度哮喘患儿仅表现为小气道功能障碍,而中重度哮喘患儿同时存在大小气道功能异常;初始与一年后比较,肺功能指标第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、最高呼气流速(peak expiratory flow,PEF)、用力呼气50%肺活量的瞬间流速(50%forced expiratory flow,FEF50)、用力呼气75%肺活量的瞬间流速(75%forced expiratory flow,FEF75)统计学存在显著差异(P<0.01)。治疗一年后,哮喘患儿Fe NO水平逐渐降低,与初始比较存在统计学差异(P<0.01)。初始Fe NO水平与肺功能的各项指标间不存在相关性(P>0.05)。结论肺功能与Fe NO两项客观指标联合应用于哮喘患儿的规范化管理中,将有助于提高哮喘患儿的疾病控制水平。Objective To evaluate the application of lung function and fractional exhaled nitric oxide （FeNO） in standardized management of asthmatic children. Methods Sixty-eight asthmatic children in our department without standard treatment were enrolled. Patients received standardized management and treatment with GINA（ Global initiative for Asthma）protocol for one year, the lung function was tested and the FeNO level was measured before treatment and 3,6, 12 months after treatment. Results Dysfunction of minor airways was founded in children with mild asthma, while dysfunction of minor and major airways was founded in moderate to severe asthmatic children. Compared to baseline parameters, the lung functional parameters one year after treatment, including forced expiratory volume in one second （ FEV1 ）, peak expiratory flow （ PEF）, 50% forced expiratory flow （ FEF50 ） ,75% forced expiratory flow （FEF75）were significantly improved（ P 〈 0.01 ）. After one year of treatment, the FeNO levels are gradually reduced（ P 〈0.01 ）. Before treatment, there was no significant correlation between the lung functional indexes and the FeNO levels（P 〉 0.05）. Conclusion Application of lung function and FeNO in standardized management may improve the control rate of asthmatic children.

关 键 词：肺功能 呼出气一氧化氮 支气管哮喘 儿童 

分 类 号：R725.6[医药卫生—儿科]