呼出气一氧化氮、一氧化碳测定及脉冲振荡肺功能检查在学龄前儿童哮喘的临床应用探讨  

Exploration Concerning Clinical Applications of Fractional Exhaled Nitric Oxide and Exhaled Carbon Monoxide Determination and Impulse Oscillometry in Preschool Children with Asthma

作　　者：徐小娟[1] 邸晓华[1] 严广荣 柴鸣荣[1] XU Xiaojuan;DI Xiaohua;YAN Guangrong(Department of Pediatrics,Dongguan People’s Hospital,Dongguan City,Guangdong Province 523059)

机构地区：[1]广东省东莞市人民医院儿科,523059

出　　处：《医学理论与实践》2021年第1期16-19,共4页The Journal of Medical Theory and Practice

基　　金：东莞市社会科技发展(重点)项目(2018507150011654)。

摘　　要：目的:探讨呼出气一氧化氮(FeNO)、呼出气一氧化碳(eCO)及脉冲振荡肺功能(IOS)检查在学龄前儿童哮喘的临床应用价值,指导临床治疗,规范管理学龄前哮喘儿童。方法:选取2018年7月—2019年6月在我院就诊的3~5岁学龄前儿童确诊哮喘58例,其中单纯哮喘组(A0组)23例,哮喘合并鼻炎组(A+AR组)35例;选用同时期就诊的确诊变应性鼻炎儿童25例(AR组)以及正常同龄儿童25例(N组)为对照组进行研究。比较急性期A0、A+AR、AR组患儿FeNO、eCO、IOS结果以及缓解期A0、A+AR、AR、N组患儿FeNO、eCO、IOS结果。结果:(1)急性期A0组、A+AR组、AR组FeNO差异有显著统计学意义(P<0.01),两两比较:A0与AR组差异有显著统计学意义(P=0.003),AR组与A+AR组差异无统计学意义(P=0.353),A0与A+AR组差异有显著统计学意义(P<0.01);3组eCO差异有统计学意义(P=0.03),两两比较:A0与AR组差异有统计学意义(P=0.028),AR组与A+AR组差异有统计学意义(P=0.012),A0与A+AR组差异无统计学意义(P=0.928);3组IOS差异无统计学意义(P=0.116)。(2)缓解期:A0组、A+AR组、AR组、N组IOS、FeNO及eCO差异均无统计学意义。结论:IOS、FeNO和eCO三者可联合检测对3~5岁学龄前哮喘儿童进行病情评估,FeNO、eCO检测操作方便,比IOS更能反映患儿哮喘发作及控制的情况,相比FeNO,eCO不受鼻炎影响更能准确反映学龄前儿童哮喘的急性发作及控制情况。Objective:To explore the clinical application value of fractional concentration of exhaled nitric oxide(FeNO)and exhaled carbon monoxide(eCO)determination and impulse oscillometry(IOS)in preschool children with asthma,so as to guide relevant clinical treatment and standardize management of preschool children with asthma.Methods:A total of 58 preschool children aged 3~5 years who were diagnosed as asthma in our hospital between July 2018 and June 2019 were selected,including 23 cases in the group of asthma(A0 group)and 35 cases in the group of asthma complicated with rhinitis(A+AR group).25 children confirmed as allergic rhinitis in our hospital during the same period(AR group)and 25 healthy children of the same age(N group)were selected as the control group for the study.The FeNO,eCO and IOS results of children at acute stage in A0,A+AR and AR groups were compared with the corresponding results of children at remittent stage in A0,A+AR,AR and N groups.Results:(1)There were statistically significant differences in FeNO between A0 group,A+AR group and AR group(P<0.01).For pairwise comparison in FeNO,the difference was statistically significant between A0 and AR groups(P=0.003),not statistically significant between AR and A+AR groups(P=0.353),and statistically significant between A0 and A+AR groups(P<0.01).In eCO,there were statistically significant differences between the 3 groups(P=0.03).For pairwise comparison in eCO,there were statistically significant differences between A0 and AR groups(P=0.028)and between AR and A+AR groups(P=0.012)while there was no statistically significant difference between A0 and A+AR groups(P=0.928).In IOS,there was no significant difference between the 3 groups(P=0.116).(2)Remittent stage:There was no significant difference in IOS,FeNO and eCO between A0,A+AR,AR,and N groups.Conclusion:IOS,FeNO and eCO can be combined for assessing the conditions of preschool children with asthma aged 3~5 years.FeNO and eCO are easy to test and more accurate than IOS in reflection of the asthma attack

关 键 词：哮喘 学龄前儿童 呼出气一氧化氮 呼出气一氧化碳 脉冲振荡肺功能 

分 类 号：R725.6[医药卫生—儿科]