中国6~18岁学龄儿童与青少年呼出气一氧化氮正常值的多中心研究  

A multi-center study on the normal range of exhaled nitric oxide in 6-18-year-old children in China

作　　者：张皓[1] 江文辉 马春艳 石永生[4] 贾春梅[5] 王金荣 韩玉玲 张月华[8] 李明[9] 王菲 于艳艳[11] 邬宇芬[1] 冯雍[12] 刘丽[13] 刘爱红[14] 张巧玲 龙珍 代富力 张艳丽[18] 计明红 马冬均 Zhang Hao;Jiang Wenhui;Ma Chunyan;Shi Yongsheng;Jia Chunmei;Wang Jinrong;Han Yuling;Zhang Yuehua;Li Ming;Wang Fei;Yu Yanyan;Wu Yufen;Feng yong;Liu Li;Liu Aihong;Zhang Qiaoling;Long Zhen;Dai Fuli;Zhang Yanli;Ji Minghong;Ma Dongjun(Department of Respiratory,National Children's Medical Center,Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200127,China;Department of Respiratory,Guangzhou Women and Children's Medical Center,Guangzhou 510623,China;Department of Pediatrics,Inner Mongolia People's Hospital,Hohhot 010017,China;Department of Pediatric Respiratory Medicine,Maternity and Child-Care Hospital of Gansu Pro-vince,Lanzhou 730050,China;Department of Pediatrics,the Fourth Hospital of Baotou,Baotou 014030,Inner Mongolia Autonomous Region,China;Department of Pediatric Respiratory,Affiliated Provincial Hospital of Shandong First Medical University,Jinan 250021,China;Department of Respiratory,Qilu Children's Hospital of Shandong University,Jinan 250022,China;Department of Pediatric Infectious Disease,the Affiliated Haikou Hospital of Xiangya Medical College,Central South University,Haikou 570208,China;Department of Respiration,Kunming Children's Hospital,Kunming 650000,China;Department of Respiratory,Maternal and Child Health Care Hospital of Guiyang,Children's Hospital of Guiyang,Guiyang 550003,China;Department of Pediatric Asthma,Lianyungang Maternal and Child Health Hospital,Lianyungang 222000,Jiangsu Province China;Department of Pediatric Respiratory Medicine,Shengjing Hospital of China Medical University,Shenyang 110004,China;the First Department of Pediatric Respiratory,the First Hospital of Jilin University,Changchun 130021,China;Department of Respiratory,Children's Hospital of Shanxi,Taiyuan 030013,China;Department of Pediatrics,Inner Mongolia Maternity and Child Health Care Hospital,Hohhot 010020,China;Department of Pediatric Respiratory Medicine,Maternal and Child Health Hospital of Hubei Province,Tongji Medical College,Huazhong University of Science

机构地区：[1]国家儿童医学中心,上海交通大学医学院附属上海儿童医学中心呼吸科,200127 [2]广州市妇女儿童医疗中心呼吸科,510623 [3]内蒙古自治区人民医院儿科,呼和浩特010017 [4]甘肃省妇幼保健院小儿呼吸内科,兰州730050 [5]包头市第四医院儿科,内蒙古包头014030 [6]山东第一医科大学附属省立医院小儿呼吸科,济南250021 [7]山东大学齐鲁儿童医院呼吸科,济南250022 [8]中南大学湘雅医学院附属海口医院儿童传染病科,海口570208 [9]昆明市儿童医院呼吸内科,650000 [10]贵阳市妇幼保健院,贵阳市儿童医院呼吸科,550003 [11]连云港市妇幼保健院儿童哮喘科,江苏连云港222000 [12]中国医科大学附属盛京医院小儿呼吸内科,沈阳110004 [13]吉林大学第一医院小儿呼吸一科,长春130021 [14]山西省儿童医院呼吸科,太原030013 [15]内蒙古自治区妇幼保健院儿科,呼和浩特010020 [16]华中科技大学同济医学院附属湖北省妇幼保健院儿童呼吸内科,武汉430070 [17]洛阳市妇幼保健院儿二科,河南洛阳471023 [18]郑州大学第三附属医院小儿呼吸科,450052 [19]中国科技大学附属第一医院儿科,合肥230001 [20]乌鲁木齐儿童医院变态反应科,830002

出　　处：《中华实用儿科临床杂志》2020年第21期1618-1623,共6页Chinese Journal of Applied Clinical Pediatrics

基　　金：上海市医学引导类(中、西医)科技支撑项目(19401931800);上海交通大学医学院中西医结合学科创新基金(18zxy007);上海市申康临床管理优化项目(SHDC12018602)。

摘　　要：目的调查中国6~18岁学龄儿童和青少年呼出气一氧化氮(FeNO)正常值范围,为中国儿童FeNO的标准建立提供数据基础。方法在中国7个行政区的16个省份进行多中心研究,通过问卷调查,确定了5949例6~18岁儿童和青少年(男3101名,女2848名)参与研究。按照美国胸科学会/欧洲呼吸协会推荐的技术标准进行FeNO测定,并探讨FeNO与性别、年龄、身高、体质量指数、地区等的关系。结果中国6~18岁儿童和青少年FeNO的几何均值为14.1 ppb,其95%置信区间(偏态分布)为1.0~38.2 ppb。6~11岁儿童的FeNO几何均值为13.1 ppb,其95%置信区间(偏态分布)为1.0~38.1 ppb;12~18岁组的FeNO几何均值为15.7 ppb,其95%置信区间(偏态分布)为2.0~38.2 ppb。11岁及以下儿童FeNO值随年龄减小而降低,每减小1岁,FeNO值降低1 ppb。多元回归分析结果显示,6~11岁儿童年龄与FeNO对数值显著相关(P<0.01);12~18岁组性别、身高、地区与FeNO对数值显著相关(均P<0.01)。结论中国儿童和青少年的FeNO值较此前的中国多中心研究(2010年至2012年)偏高。对12~18岁年龄,推荐采用16 ppb作为临床切点。对11岁及以下儿童,考虑年龄的影响,年龄每减小1岁,FeNO切点值降低1 ppb。Objective To investigate the normal range of exhaled nitric oxide(FeNO)in 6-18-year-old children in China,so as to provide a data base for the establishment of FeNO standards for Chinese children.Methods A multi-center study was conducted on 5949 children aged 6-18(3101 males and 2848 females)in 16 pro-vinces of 7 administrative districts in China.According to the technical standard recommended by American Thoracic Society/European Respiratory Association,FeNO was measured,and the relationship of FeNO with the sex,age,height,weight,body mass index and region was discussed.Results The geometric mean FeNO value of Chinese children aged 6-18 was 14.1 ppb,and its 95% confidence interval(skewness distribution)was 1.0-38.2 ppb.The geometric mean FeNO values of children aged 6-11 and 12-18 were 13.1 ppb and 15.7 ppb,respectively,and their 95% confidence intervals(skewness distribution)were 1.0-38.1 ppb and 2.0-38.2 ppb.For children at and under 11 years old,FeNO decreased with age,with a mean decline of 1 ppb per year.The multiple linear regression results suggested that there was a significant correlation between FeNO and age for children aged 6-11,and FeNO of children aged 12-18 was significantly correlated with the gender,height,and region(all P<0.01).Conclusions FeNO values of Chinese children and adolescents in this study are higher than those obtained by the previous study conducted from 2010 to 2012.For children aged 12-18,16 ppb is recommended as the clinical cut-off point.For children at or under 11 years old,the influence of age on FeNO should be considered,and the cut-off point of FeNO decreases by 1 ppb as the age is reduced by one year.

关 键 词：呼出气一氧化氮 正常值 儿童及青少年 呼吸道炎症 

分 类 号：R725.6[医药卫生—儿科]