过敏性鼻炎对哮喘儿童肺功能及呼出气一氧化氮的影响  

Effects of allergic rhinitis on lung function and exhaled nitric oxide in children with asthma

作　　者：孙瑜 陆美华[1] 冯庆国[1] 陶黎梅[1] 唐建东[1] SUN Yu;LU Meihua;FENG Qingguo;TAO Limei;TANG Jiandong(Pediatric Department,Changshu Hospital of Chinese Medicine,Changshu 215500,China)

机构地区：[1]常熟市中医院儿科,江苏常熟215500

出　　处：《中国中西医结合儿科学》2022年第3期193-196,共4页Chinese Pediatrics of Integrated Traditional and Western Medicine

摘　　要：目的分析支气管哮喘合并过敏性鼻炎患儿肺功能改变及呼出气一氧化氮(FeNO)特征。方法回顾性分析2020年9月至2021年2月我院儿科门诊85例支气管哮喘轻-中度急性发作患儿。(1)根据有无合并过敏性鼻炎,将85例支气管哮喘患儿分为哮喘合并鼻炎组47例和支气管哮喘组38例。(2)根据是否使用鼻用糖皮质激素,将哮喘合并鼻炎组47例分为联合治疗组28例和吸入糖皮质激素(ICS)治疗组19例。对比支气管哮喘组与哮喘合并鼻炎组急性发作期肺功能及FeNO差异;对比ICS治疗组与联合治疗组在治疗3个月后肺功能及FeNO差异。结果(1)急性发作期:哮喘合并鼻炎组与支气管哮喘组的肺功能指标:呼气峰值流量占预计值百分比(PEF%pred)、第1秒用力呼气容积占预计值百分比(FEV1%pred)、第1秒用力呼气容积与用力肺活量的比值占预计值百分比(FEV1/FVC%pred)、用力呼出50%肺活量时的瞬间呼气流量占预计值百分比(FEF50%pred)、用力呼出75%肺活量时的瞬间呼气流量占预计值百分比(FEF75%pred)、最大呼气中期流量占预计值百分比(MMEF%pred)比较差异无统计学意义(P>0.05);哮喘合并鼻炎组FeNO高于支气管哮喘组,差异有统计学意义(P<0.01)。(2)哮喘合并鼻炎患儿在治疗3个月后,联合治疗组FEF50%pred、FEF75%pred、MMEF%pred高于ICS治疗组,差异有统计学意义(P<0.05);联合治疗组FeNO值低于ICS治疗组,差异有统计学意义(P<0.05)。(3)哮喘合并鼻炎组急性发作期与治疗3个月,FeNO水平与肺功能小气道指标FEF50%、FEF75%及MMEF%均呈负相关(P<0.05)。结论支气管哮喘合并过敏性鼻炎患儿FeNO明显升高,联合治疗更利于改善患儿肺功能及气道炎症。Objective To analyze the changes of lung function and characteristics of exhaled nitric oxide in children with bronchial asthma and allergic rhinitis.Methods A retrospective analysis was performed in 85 children with mild to moderate acute episodes of bronchial asthma from September 2020 to February 2021 in the pediatric outpatient department of our hospital.According to the group of presence or absence of allergic rhinitis,the 85 children were divided into the bronchial asthma group and the group of asthma combined with rhinitis.According to whether children with asthma and rhinitis used nasal corticosteroids(NICS),the 47 children were divided into combined treatment group(n=28)and the group of inhalation of corticosteroids(ICS group,n=19).The lung function and FeNO were compared between bronchial asthma group and the group of asthma with rhinitis at acute stage.Compare the lung function and exhaled nitric oxide in the ICS treatment group and the combined treatment group after 3 months of treatment.Results(1)During the acute episode,there was no statistical difference in the following pulmonary function indexes:PEF%pred,FEV1%pred,FEV1/FVC%pred,FEF50%pred,FEF75%pred or MMEF%pred between the asthma combined with rhinitis group and the bronchial asthma group(P>0.05);FeNO in the asthma combined with rhinitis group was higher than that in the bronchial asthma group,and the difference was statistically significant(P<0.01).(2)After 3 months of treatment in children with asthma and rhinitis,FEF50%pred,FEF75%pred,and MMEF%pred in the combined treatment group were higher than those in the ICS treatment group,the difference being statistically significant(P<0.05);the FeNO value of the combined treatment group was lower than that of the ICS treatment group,and the difference was statistically significant(P<0.05).(3)In the asthma combined with rhinitis group,the level of FeNO was negatively correlated with FEF50%,FEF75%and MMEF%of small airway indicators of lung function during acute attack and at 3 months of treatment(P<0.0

关 键 词：支气管哮喘 过敏性鼻炎 肺功能 呼出气一氧化氮 吸入糖皮质激素 儿童 

分 类 号：R725.6[医药卫生—儿科]