呼出气一氧化氮浓度检测在儿童咳嗽变异性哮喘中的应用(1)
摘 要：目的 探讨FeNO检测在儿童咳嗽变异性哮喘中的临床价值。方法 选择2016年3月～2017年3月在我院确诊为CVA的患儿80例及健康儿童40例作为研究对象，比较两组儿童FeNO水平，比较FeNO正常的CVA患儿与FeNO升高患儿的皮肤点刺结果、肺功能，分析CVA患儿FeNO水平与肺功能的相关性。结果 CVA患儿FeNO水平高于健康儿童，差异有统计学意义(P<0.05)。同FeNO正常的CVA患儿相比，FeNO升高的CVA患儿拥有更高的体重指数，皮肤点刺阳性率更高，强度更强，差异有统计学意义(P<0.05)，但两组患儿肺功能无统计学差异，CVA患儿FeNO水平与肺功能无相关性(P>0.05)。结论 FeNO可以辅助诊断CVA，但不能作为评估病情严重程度的指标。
关键词：呼出气一氧化氮浓度；儿童；咳嗽变异性哮喘
中图分类号：R725.6 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.13.026
, http://www.100md.com
文章编号：1006-1959(2018)13-0091-04
Abstract：Objective To investigate the clinical value of FeNO detection in children with cough variant asthma.Methods From March 2016 to March 2017，80 children with CVA diagnosed in our hospital and 40 healthy children were selected as study subjects. The levels of FeNO in the two groups were compared，and the results of skin prick and pulmonary function were compared between the CVA children with normal FeNO and the children with elevated FeNO.To analyze the correlation between FeNO level and lung function in children with CVA.Results FeNO level in CVA children was higher than that in healthy children，the difference was statistically significant(P<0.05).Compared with the CVA children with normal FeNO，CVA patients with elevated FeNO had higher body mass index，higher skin prick positive rate and stronger intensity，the difference was statistically significant(P<0.05)，but there was no significant correlation between FeNO level and lung function in CVA children(P>0.05).Conclusion FeNO can assist in the diagnosis of CVA，but it can not be used as an index to evaluate the severity of the disease.
, 百拇医药
Key words：Exhalation nitric oxide concentration；Children；Cough variant asthma
咳嗽变异性哮喘(cough variant asthma，CVA)是引起我国儿童慢性咳嗽的常见原因之一，其发病机制目前尚不明确，目前认为其和典型的支气管哮喘类似，如气道高反应性、嗜酸性粒细胞气道炎症及由此导致的气道重塑[1]。CVA的病程长，病情易反复，严重影响患者的生活质量，部分患者可进展为典型的支气管哮喘。因此，加强咳嗽变异性的诊断及治疗显得尤为重要。呼出气一氧化氮浓度(fractional exhaled nitric oxide， FeNO)检测是一种快速、安全、无创的定量反应气道炎症的技术，是反应气道嗜酸性粒细胞炎症的指标[2]。因此本研究初步探讨FeNO检测在儿童咳嗽变异性哮喘中的临床价值。
1资料与方法
1.1临床资料 2016年3月～2017年3月于成都市妇女儿童中心医院小儿呼吸科确诊为CVA的患儿80例，诊断符合《中国儿童慢性咳嗽诊断与治疗指南(2013年修订)》中提出的关于咳嗽变异性哮喘的诊断标准[3]，所有患儿进行FeNO测定、皮肤点刺试验及肺功能检查，根据FeNO水平分为FeNO正常组(≤24 ppb)、FeNO升高组(>24 ppb)[4]。并纳入同期在呼吸科门诊体检的健康儿童40例作为对照组，仅行FeNO测定。
1.2检查方法
1.2.1 FeNO测定 采用瑞典Aerocrime公司生产的呼出气一氧化氮测定系统分析仪。要求患者在两周内无其他呼吸道感染史，在检查前1 h内无剧烈体力活动、主动或接受被动吸烟。在检查前2 h内禁食富含氮的食物(如香肠、动物内脏、莴苣或菠菜等)、禁喝含咖啡因的饮料。测定时要求受试者取站立位或坐位，吸入無NO 的气体达到肺总量，后以50 ml/s的气流速度呼出，至呼出气达稳定的平台期后维持10 s以上，系统即可测出相应的FeNO检测值。测定结果采用单位百亿分率( parts per billion， ppb) 表示[5]。, 百拇医药(胡帅 张蕾 罗荣华)
关键词：呼出气一氧化氮浓度；儿童；咳嗽变异性哮喘
中图分类号：R725.6 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.13.026
, http://www.100md.com
文章编号：1006-1959(2018)13-0091-04
Abstract：Objective To investigate the clinical value of FeNO detection in children with cough variant asthma.Methods From March 2016 to March 2017，80 children with CVA diagnosed in our hospital and 40 healthy children were selected as study subjects. The levels of FeNO in the two groups were compared，and the results of skin prick and pulmonary function were compared between the CVA children with normal FeNO and the children with elevated FeNO.To analyze the correlation between FeNO level and lung function in children with CVA.Results FeNO level in CVA children was higher than that in healthy children，the difference was statistically significant(P<0.05).Compared with the CVA children with normal FeNO，CVA patients with elevated FeNO had higher body mass index，higher skin prick positive rate and stronger intensity，the difference was statistically significant(P<0.05)，but there was no significant correlation between FeNO level and lung function in CVA children(P>0.05).Conclusion FeNO can assist in the diagnosis of CVA，but it can not be used as an index to evaluate the severity of the disease.
, 百拇医药
Key words：Exhalation nitric oxide concentration；Children；Cough variant asthma
咳嗽变异性哮喘(cough variant asthma，CVA)是引起我国儿童慢性咳嗽的常见原因之一，其发病机制目前尚不明确，目前认为其和典型的支气管哮喘类似，如气道高反应性、嗜酸性粒细胞气道炎症及由此导致的气道重塑[1]。CVA的病程长，病情易反复，严重影响患者的生活质量，部分患者可进展为典型的支气管哮喘。因此，加强咳嗽变异性的诊断及治疗显得尤为重要。呼出气一氧化氮浓度(fractional exhaled nitric oxide， FeNO)检测是一种快速、安全、无创的定量反应气道炎症的技术，是反应气道嗜酸性粒细胞炎症的指标[2]。因此本研究初步探讨FeNO检测在儿童咳嗽变异性哮喘中的临床价值。
1资料与方法
1.1临床资料 2016年3月～2017年3月于成都市妇女儿童中心医院小儿呼吸科确诊为CVA的患儿80例，诊断符合《中国儿童慢性咳嗽诊断与治疗指南(2013年修订)》中提出的关于咳嗽变异性哮喘的诊断标准[3]，所有患儿进行FeNO测定、皮肤点刺试验及肺功能检查，根据FeNO水平分为FeNO正常组(≤24 ppb)、FeNO升高组(>24 ppb)[4]。并纳入同期在呼吸科门诊体检的健康儿童40例作为对照组，仅行FeNO测定。
1.2检查方法
1.2.1 FeNO测定 采用瑞典Aerocrime公司生产的呼出气一氧化氮测定系统分析仪。要求患者在两周内无其他呼吸道感染史，在检查前1 h内无剧烈体力活动、主动或接受被动吸烟。在检查前2 h内禁食富含氮的食物(如香肠、动物内脏、莴苣或菠菜等)、禁喝含咖啡因的饮料。测定时要求受试者取站立位或坐位，吸入無NO 的气体达到肺总量，后以50 ml/s的气流速度呼出，至呼出气达稳定的平台期后维持10 s以上，系统即可测出相应的FeNO检测值。测定结果采用单位百亿分率( parts per billion， ppb) 表示[5]。, 百拇医药(胡帅 张蕾 罗荣华)