呼出一氧化氮水平与反复喘息婴幼儿哮喘预测指数、血免疫球蛋白E水平的关系  

Relationship of exhaled nitric oxide level with asthma predictive index and blood immunoglobulin E levels in infants with recurrent wheezing

作　　者：及立立[1] 黄坤玲[1] 路素坤[1] 曹丽洁[1] 牛波[1] 刘建华[1] JI Li-li;HUANG Kun-ling;LU Su-kun;CAO Li-jie;NIU Bo;LIU Jian-hua(Children's Hospital of Hebei Province,Shijiazhuang,Hebei 050031,China)

机构地区：[1]河北省儿童医院,河北石家庄050031

出　　处：《临床肺科杂志》2020年第7期1046-1049,共4页Journal of Clinical Pulmonary Medicine

基　　金：河北省2016年度医学科学研究重点课题计划(No.20160413)。

摘　　要：目的探讨呼出一氧化氮(FeNO)水平与反复喘息婴幼儿哮喘预测指数(API)、血免疫球蛋白E(IgE)水平的关系。方法选取2015年10月至2016年10月收集我院呼吸科病房住院的反复喘息(既往喘息≥2次)婴幼儿68例为研究对象(观察组),测定患儿喘息急性期、喘息缓解24小时后、出院1月呼出气一氧化氮浓度,抽血化验血清总IgE水平,并选取同期在我院心外科、胸外科、泌尿外科术前6月~3岁患儿36例纳入对照组,测定呼出气一氧化氮浓度及血清总IgE水平,探讨呼出NO水平与反复喘息婴幼儿哮喘预测指数、血IgE水平的关系。结果对照组患儿FeNO、IgE、白介素-17(IL-17)水平均显著低于观察组各时期(喘息急性期、喘息缓解24小时后、出院1月)患儿,但最大呼气量(PEF)、一分钟用力呼气量(FEV1)明显高于观察组各时期(喘息急性期、喘息缓解24小时后、出院1月)患儿(P<0.05),喘息急性期、喘息缓解24小时后、出院1月患儿FeNO、IgE、IL-17水平呈现递减趋势,PEF、FEV1呈现递增趋势;68例患者中API阳性者34例,API阴性者26例,且API阳性者FeNO、IgE水平均显著高于API阴性者(P<0.05);反复喘息婴幼儿FeNO与API、IgE水平均呈正相关(P<0.05);反复喘息婴幼儿PEF、FEV1与FeNO、IgE、IL-17水平均呈负相关(P<0.05)。结论反复喘息婴幼儿FeNO、API、IgE有增高趋势,且FeNO与API、IgE存在正相关,而FeNO、IgE、IL-17与患儿肺功能指标PEF、FEV1也有一定关系,提示对反复喘息婴幼儿进行FeNO、API、IgE、IL-17检测,可为其尽早长期诊治提供依据。Objective To investigate the relationship of fractional exhaled nitric oxide(FeNO)level with asthma predictive index(API)and blood immunoglobulin E(IgE)levels in infants with recurrent wheezing.Methods 68 infants with recurrent wheezing(previous wheezing not less than twice)hospitalized in the Respiratory Department of the hospital from October 2015 to October 2016 were selected as the study subjects(the observation group).The concentrations of exhaled NO in acute phase of wheezing,24 h after wheezing relief and 1 month after discharge were measured.Blood samples were collected to determine total serum IgE levels.36 children between 6 months old and 3 years old in the Department of Cardiac Surgery,Department of Thoracic Surgery,and Urology Department before surgery were selected as the control group.The concentration of exhaled NO and total serum IgE levels were determined.The relationship between exhaled NO levels and asthma predictive index and blood IgE levels in infants with recurrent wheezing was discussed.Results The levels of FeNO,IgE and interleukin-17(IL-17)in the control group were significantly lower,and the peak expiratory flow(PEF)and forced expiratory volume in 1 s(FEV 1)were significantly higher than those in the observation group at different time(acute phase of wheezing,24 h after wheezing relief and 1 month after discharge).The levels of FeNO,IgE and IL-7 showed a decreasing trend while PEF and FEV 1 showed an increasing trend in the acute phase of wheezing,24 h after wheezing relief and 1 month after discharge.Among the 68 patients,there were 34 API positive cases and 26 API negative cases.The levels of FeNO and IgE were significantly higher in API positive patients than in API negative patients(P<0.05).FeNO was positively correlated with API and IgE levels in infants with recurrent wheezing(P<0.05).PEF and FEV 1 were negatively correlated with FeNO,IgE and IL-17 levels in infants with recurrent wheezing(P<0.05).Conclusion FeNO,API and IgE in infants with recurrent wheezing show an increasing t

关 键 词：呼出一氧化氮 反复喘息 婴幼儿 哮喘预测指数 血免疫球蛋白E 

分 类 号：R725.6[医药卫生—儿科]