哮喘患儿呼出气一氧化氮及外周血嗜酸粒细胞的变化

Changes of exhaled nitric oxide and peripheral blood eosinophils in children with asthma

摘要:

目的：检测支气管哮喘（AS），AS合并过敏性鼻炎（AS/AR）及慢性咳嗽变异性哮喘（CVA）患儿中呼出气一氧化氮（eNO）和外周血嗜酸粒细胞（EOS）的水平及两者的相关性，以探讨eNOS检测在AS儿童中的应用。方法：采用电化学法对5～14岁患有AS（n=12）、AS/AR（n=29）、CVA（n=10）的患儿进行eNO测定，同时测定EOS及一秒钟用力呼气容积占预计值百分比（FEV1％）。30例无特异性疾病史和家族过敏史，且近两周无急性呼吸道感染史的儿童作为对照组。结果：AS，AS/AR，CVA 3组eNO和EOS水平均高于对照组（P＜0.01）；AS/AR组eNO（50.3±6.7 ppb）和EOS水平（5.9±4.2×109）高于AS组（30.5±8.8 ppb，4.2±3.2×109）及CVA组（26.0±3.2 ppb，3.7±6.9×109）（均P＜0.05），而AS、CVA组间差异无显著性；AS组eNO与EOS呈正相关（r＝0.51，P＜0.05），但与FEV1无相关性（r＝0.144，P＞0.05）。结论：eNO在过敏性体质中高表达，且eNO可以反映AS患者气道嗜酸性炎症水平。［中国当代儿科杂志，2009，11（12）：986-988］

Abstract:

OBJECTIVE: This study examined the levels of exhaled nitric oxide (eNO) and peripheral blood eosinophils (EOS) as well as the correlation between the two markers in children with bronchial asthma (AS)，AS complicated by allergic rhinitis (AS/AR) and chronic cough variant asthma (CVA), in order to explore the value of eNOS detection in children with AS. METHODS: The eNO level was measured using light-emitting electrochemical photometry in 12 children with AS, 29 children with AS/AR and 10 children with CVA. Peripheral blood EOS was counted by blood cell counter (Coulter JT). Forced expiratory volume in one second (FEV1) was assessed by lung function measurement. Thirty children without atopic disease and acute respiratory infection as well as without a family history of atopic diseasea served as the control group. RESULTS: The levels of eNO and blood EOS in the AS, the AS/AR and the CVA groups were significantly higher than those in the control group (P<0.01). The AS/AR group showed increased levels of eNO (50.3±6.7 ppb) and EOS (5.9±4.2×109 ) compared with the AS (30.5±8.8 ppb and 4.2±3.2×109 respectively) and the CVA groups (26.0±3.2 ppb and 3.7±6.9×109 respectively) (P<0.05). There were no significant differences in eNO and EOS levels between the AS and the CVA groups. The eNO level was positively correlated with the EOS level (r=0.51, P<0.05), but not with FEV1 (r=0.144, P>0.05) in the AS group. CONCLUSIONS: NO is highly expressed in children with symptoms of atopy and can reflect the levels of eosinophilic airway inflammation in children with AS.［Chin J Contemp Pediatr, 2009, 11 (12):986-988］