呼出气温度对儿童哮喘气道炎症变化的预测意义

Predictive significance of exhaled breath temperature for airway inflammation changes in children with asthma

摘要:

目的 探讨呼出气温度（EBT）对哮喘患儿气道炎症变化的预测意义。方法 选择门诊初诊时符合纳入标准的哮喘患儿60例作为哮喘组，另选60例健康儿童作为对照组，应用最新的三代产品（X-halo）检测EBT水平，记录儿童哮喘控制测试（C-ACT）评分，比较哮喘组和对照组EBT水平和C-ACT评分差异。1个月后复诊根据患儿C-ACT评分，将其分为良好控制组、部分控制组和未控制组，检测三组EBT和FeNO水平，比较三组EBT水平和C-ACT评分差异，分析EBT和FeNO相关性。追溯其初诊资料，比较初诊时三组EBT水平和C-ACT评分差异，最后比较复诊和初诊时三组EBT水平和C-ACT评分的差异。结果 初诊时，哮喘组EBT水平显著高于对照组（P < 0.05），C-ACT评分显著低于对照组（P < 0.05）。复诊时，不同控制水平的三组EBT比较差异有统计学意义，即未控制组 > 部分控制组 > 良好控制组（P < 0.05）；三组C-ACT评分比较差异亦有统计学意义，即良好控制组 > 部分控制组 > 未控制组（P < 0.05）。三组初诊EBT水平和C-ACT评分的组间比较差异均无统计学意义（P > 0.05）。与初诊时比较，复诊时良好控制组EBT明显降低（P < 0.05），部分控制组和未控制组均明显升高（P < 0.05）；良好控制组和部分控制组C-ACT评分均明显升高（P < 0.05），未控制组明显降低（P < 0.05）。复诊时未控制组EBT和FeNO水平呈正相关（P < 0.05）。结论 EBT对儿童哮喘气道炎症的变化具有预测意义。

Abstract:

Objective To explore the predictive significance of exhaled breath temperature (EBT) for airway inflammation changes in children with asthma. Methods A total of 60 children with asthma who met the inclusion criteria at the first visit were chosen as the asthma group, and 60 healthy children were selected as the control group. The EBT level was measured by the latest third-generation product (X-halo). The Childhood Asthma Control Test (C-ACT) score was recorded. EBT level and C-ACT score were compared between the asthma and control groups. At the subsequent visit one month later, the children were divided into well-controlled, partially-controlled, and uncontrolled groups according to their C-ACT scores. The EBT level and the FeNO level of the three groups were measured. EBT level and C-ACT score were compared among the three groups. The correlation between EBT and FeNO was analyzed. The data of initial diagnosis were reviewed, the EBT level and C-ACT score at the first visit were compared among the three groups, and the differences in EBT level and C-ACT score among the three groups at the second and first visits were evaluated. Results At the first visit, the asthma group had a significantly higher EBT and a significantly lower C-ACT score compared with the control group (P < 0.05). At the time of the subsequent visit, there was a significant difference in EBT level between the three groups, i.e., uncontrolled group > partially-controlled group > well-controlled group (P < 0.05), and there was also a significant difference in C-ACT score between the three groups, i.e., well-controlled group > partially-controlled group > uncontrolled group (P < 0.05). There were no significant differences in EBT level and C-ACT score at the first visit between the three groups. From the first visit to the subsequent visit, EBT level was significantly decreased in the well-controlled group (P < 0.05), but significantly increased in both partially-controlled group uncontrolled groups (P < 0.05); C-ACT score was significantly increased in the well-controlled and partially-controlled groups (P < 0.05), but significantly decreased in the uncontrolled group (P < 0.05). EBT and FeNO levels at the subsequent visit were positively correlated with each other in the uncontrolled group (P < 0.05). Conclusions EBT has predictive significance for the changes in airway inflammation in children with asthma.