济南市6~18岁儿童呼出气一氧化氮正常值研究  

A study of normal values of exhaled nitric oxide in children aged 6 to 18 years in Jinan

作　　者：郑文松 王金荣[2] 韩玉玲 王峻[4] 刘志刚[5] 王珊珊 李孟辉 杨娟 马香 杨金枝 王明明 王丹 Zheng Wensong;Wang Jinrong;Han Yuling;Wang Jun;Liu Zhigang;Wang Shanshan;Li Menghui;Yang Juan;Ma Xiang;Yang Jinzhi;Wang Mingming;Wang Dan(Second Clinical Medical College of Shandong University of Traditional Chinese Medicine,Jinan 250355,China;Department of Pediatric Respiration,Shandong Provincial Hospital,Shandong University,Jinan 250021,China;Department of Pe-diatric Respiration,Qilu Children′s Hospital,Shandong University,Jinan 250022,China;Department of Pediatrics,Jinan Central Hospital,Jinan 250013,China;Department of Pediatrics,Jinan Maternal and Child Health Hospital,Jinan 250001,China;Public Health Branch,Shandong Provincial Hospital,Shandong University,Jinan 250021,China)

机构地区：[1]山东中医药大学第二临床医学院,济南250355 [2]山东大学附属省立医院小儿呼吸科,济南250021 [3]山东大学齐鲁儿童医院小儿呼吸科,济南250022 [4]济南市中心医院儿科,250013 [5]济南市妇幼保健院儿科,250001 [6]山东大学附属省立医院公共卫生科,济南250021

出　　处：《中华实用儿科临床杂志》2020年第13期1014-1018,共5页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的调查济南市6~18岁健康儿童呼出气一氧化氮正常值范围。方法选取2017年10月11日至26日济南市6~18岁在校健康儿童,进行问卷调查、体格检查及呼出气一氧化氮检测。采用电化学原理的检测方法分别测定50 mL/s流速时口呼出气一氧化氮(FeNO50)、200 mL/s流速时口呼出气一氧化氮(FeNO200)、肺泡一氧化氮(CaNO)及10 mL/s流速时鼻呼出气一氧化氮(FnNO10)水平。分析FeNO50、FeNO200、CaNO和FnNO10分布情况,并应用多元线性回归模型分析各指标与性别、年龄、身高、体质量指数(BMI)的关联。结果本研究共纳入772名健康儿童,其中男364名,女408名;年龄12.1(11.8~12.3)岁,身高154.8(153.6~156.0)cm,BMI 20.3(20.0~20.6)kg/m2。FeNO50、FeNO200、CaNO、FnNO10测量值分别波动于3.0~168.0 ppb、2.0~44.0 ppb、0.5~44.2 ppb、0~1253.0 ppb。FeNO50、FeNO200、CaNO均呈偏态分布,其95%上限值分别为35.0 ppb、13.3 ppb和8.5 ppb。FeNO50在男童中的几何均值(95%CI)为14.6(13.7~15.5)ppb,高于女童[13.3(12.7~14.0)ppb],差异有统计学意义(Z=1.470,P=0.027);在多元线性回归中,FeNO50与年龄、身高均呈正相关(β=0.023、0.007,均P<0.05),与BMI呈负相关(β=-0.016,P<0.05)。FeNO200在男性中几何均值(95%CI)为7.1(6.8~7.4)ppb,高于女童[6.4(6.1~6.6)ppb],差异有统计学意义(Z=1.747,P=0.004);在多元线性回归中,FeNO200与身高呈正相关(β=0.005,P<0.05),与性别呈负相关(女童:β=-1.126,P<0.05)。男童与女童间CaNO比较差异无统计学意义(P>0.05),其与性别、年龄、身高、BMI均无相关性(均P>0.05)。FnNO10呈正态分布,其均值为456.2 ppb,95%CI为29.3~863.4 ppb,男童均值(95%CI)为408.7(377.1~443.0)ppb,高于女童[368.8(339.0~401.3)ppb],差异有统计学意义(Z=1.722,P=0.005);在多元线性回归中与性别相关(β=-36.098,P<0.05),与年龄、身高、BMI均无相关性(均P>0.05)。结论济南6~18岁健康儿童FeNO50、FeNO200、CaNO和FnNO10指标的正常值范围分别为3.0~35.0 ppb、2.0~13.3 ppb、Objective To investigate the normal range of exhaled nitric oxide in healthy children aged 6-18 in Jinan.Methods The healthy school children aged 6-18 in Jinan from October 11 to 26,2017 were selected for questionnaire survey,physical examination and exhaled nitric oxide test.The levels of mouth exhaled nitric oxide at the flow rate of 50 mL/s(FeNO50)and mouth exhaled nitric oxide at the flow rate of 200 mL/s(FeNO200),alveolar nitric oxide(CaNO),and nasal exhaled nitric oxide at the flow rate of 10 mL/s(FnNO10)were measured by the electroche-mical method.The distributions of FeNO50,FeNO200,CaNO and FnNO10 were analyzed,and their correlations with gender,age,height and body mass index(BMI)were discussed by the multiple linear regression model.Results A total of 772 healthy children were enrolled in this study,including 364 males and 408 females,with a median age of 12.1(11.8-12.3)years old,a median height of 154.8(153.6-156.0)cm,and a median BMI of 20.3(20.0-20.6)kg/m2.The measured values of FeNO50,FeNO200,CaNO and FnNO10 fluctuated in the range of 3.0-168.0 ppb,2.0-44.0 ppb,0.5-44.2 ppb and 0-1253.0 ppb,respectively.FeNO50,FeNO200 and CaNO values showed skewed a distribution,and their 95%upper limits were 35.0 ppb,13.3 ppb and 8.5 ppb,respectively.The geometric mean(95%CI)of FeNO50 in males(95%CI)[14.6(13.7-15.5)ppb]was significantly higher than that in females[13.3(12.7-14.0)ppb],and the difference was statistically significant(Z=1.470,P=0.027).The multiple linear regression results suggested that,FeNO50 was positively correlated with age and height(β=0.023,0.007,respectively,all P<0.05),and negatively correlated with BMI(β=-0.016,P<0.05).The geometric mean(95%CI)of FeNO200in males[7.1(6.8-7.4)ppb]was significantly higher than that in females[6.4(6.1-6.6)ppb],and the difference was statistically significant(Z=1.747,P=0.004).The multiple linear regression results suggested that,FeNO200 was positively correlated with height(β=0.005)and negatively correlated with gender(femaleβ=-1.126)(all P<0.05).There was no

关 键 词：呼出气一氧化氮 正常值 儿童 气道炎症 

分 类 号：R562[医药卫生—呼吸系统]