上下气道呼出气一氧化氮与哮喘控制水平的相关性研究

Correlation of fractional exhaled nitric oxide in the upper and lower airways with the level of asthma control

摘要:

目的 探讨联合检测呼出气一氧化氮（FeNO）及鼻呼出气一氧化氮（FnNO）的临床价值及其与哮喘控制水平的关系。方法 选取2018年1~6月诊断为哮喘并处于慢性持续期的患儿120例为研究对象。所有患儿进行儿童哮喘控制测试（C-ACT），得分 > 23分为控制组，20~23分为部分控制组，≤ 19分为未控制组，每组各40例；同时依据哮喘患儿有无合并过敏性鼻炎分为未合并鼻炎组（n=55）和合并鼻炎组（n=65）；同期收集健康体检儿童40例为对照组。哮喘患儿及对照组儿童均检测FeNO与FnNO水平。结果 不同水平控制组内FeNO值以未控制组最高，部分控制组其次，控制组最低（P < 0.05），其中未控制组及部分控制组FeNO值高于对照组（P < 0.05）；未控制组与部分控制组FnNO值高于完全控制组及对照组（P < 0.05），完全控制组FnNO值高于对照组（P < 0.05）。合并鼻炎组FeNO与FnNO值均高于未合并鼻炎组（P < 0.05）。结论 FeNO可用来评估哮喘控制情况，与FnNO联合可评估上下气道炎症情况，为上下气道联合治疗提供依据。

Abstract:

Objective To study the clinical value of combined measurement of fractional exhaled nitric oxide (FeNO) and nasal fractional exhaled nitric oxide (FnNO) and its correlation with the level of asthma control. Methods A total of 120 children who were diagnosed with asthma from January to June, 2018 and were in the chronic persistent stage were enrolled as subjects. The childhood asthma control test (C-ACT) was performed for all the 120 children. According to the C-ACT score, these children were divided into 4 groups:complete control group with a C-ACT score of > 23, partial control group with a C-ACT score of 20-23, and uncontrolled group with a C-ACT score of ≤ 19 (n=40 each). According to the presence or absence of allergic rhinitis, they were divided into 2 groups:non-rhinitis group with 55 children and rhinitis group with 65 children. A total of 40 children who underwent physical examination during the same period of time were enrolled as the control group. FeNO and FnNO levels were measured for all the 120 children. Results The uncontrolled group had the highest level of FeNO, followed by the partial control group and the complete control group (P < 0.05). The uncontrolled and partial control groups had a significantly higher level of FeNO than the control group (P < 0.05). The uncontrolled and partial control groups had a significantly higher level of FnNO than the complete control and control groups (P < 0.05). The rhinitis group had significantly higher FeNO and FnNO levels than the non-rhinitis group (P < 0.05). Conclusions FeNO can be used to assess the level of asthma control in children, and its combination with FnNO may be useful for the evaluation of the degree of inflammation in the upper and lower airways and provide a basis for the combined treatment of the upper and lower airways.