莫巧字，曾　嵘

(1.四川省都江堰市妇幼保健院儿科，四川 都江堰 611830；2.四川省宜宾市第一人民医院儿科，四川 宜宾 644000)



呼出气一氧化氮检测对儿童哮喘的临床意义

莫巧字1，曾嵘2

(1.四川省都江堰市妇幼保健院儿科，四川 都江堰 611830；2.四川省宜宾市第一人民医院儿科，四川 宜宾 644000)

目的探讨呼出气一氧化氮(ENO)检测在儿童哮喘控制评估中的临床价值。方法120例哮喘患儿，根据儿童哮喘控制测试(C-ACT)评分，分为哮喘未控制组(C-ACT<20分)50例和哮喘控制组(C-ACT≥20分)70例；120例哮喘患儿，根据2014版GINA指南分为重度组38例、中度组46例及轻度组36例、30例健康儿童为对照组。所有研究对象均进行ENO和肺功能(FEV1%、PEF%)检测，分析ENO水平与FEV1%、PEF%的相关性。结果哮喘控制组、非控制组及对照组3组组间ENO水平比较差异均有统计学意义(F=90.72，P<0.05)；重度组、中度组、轻度组及对照组4组组间ENO水平差异具有统计学意义(F=1123.78，P<0.05)；哮喘非控制组、控制组、重度组、中度组和轻度组ENO水平与肺功能FEV1%和PEF%均无相关性(r值介于-0.097～-0.027，均P>0.05)。结论ENO是气道炎症反应的良好指标，可作为监测儿童哮喘严重程度及控制状况的指标。

呼出气一氧化氮；支气管哮喘；肺功能；儿童

[Abstract]Objective To explore the clinical value of exhaled nitric oxide (ENO) test for the assessment of asthma in children.Methods Thirty cases of healthy children were selected as control group. According to scores of childhood asthma control test (C-ACT), 120 cases of children with asthma were divided into two groups, uncontrolled group (n=50 and C-ACT<20) and controlled group (n=70 and C-ACT≥ 20). Moreover, 120 cases of children patients with asthma were divided into three groups, namely severe group (n=38), moderate group (n=46) and mild group (n=36) in accordance with GINA2014. All research objects received ENO test and pulmonary function (FEV1%, PEF%) test. The correlation between ENO level and FEV11%, PEF% was analyzed. Results By comparing the level of ENO between uncontrolled group, controlled group and control group, results showed that there were statistically significant differences between each two groups (F=90.72,P<0.05). There were statistically significant differences in the level of ENO in severe group, moderate group, mild group and control group between each two groups (F=1 123.78,P<0.05). There was no significant correlation between ENO and pulmonary function (FEV1%, PEF%) in any group (rvalue ranged -0.097 to -0.027, allP>0.05). Conclusion The detection of ENO is a good indicator of airway inflammation reaction, which can he used as an indicator to monitor childhood asthma severity and the condition of the control.

[Key words]exhaled nitric oxide (ENO); asthma; pulmonary function; children

支气管哮喘是全球范围内常见的慢性呼吸道疾病。根据世界卫生组织的一份报告，全球目前有3亿多人患有哮喘，近年来哮喘的发病率仍然在逐年增加[1]。因此哮喘的早期诊断和治疗显得尤为重要。呼出气一氧化氮(ENO)检测是一种非侵入性气道炎症检测方法，可以作为气道炎症的无创性标志物，在国内外ENO检测广泛应用于临床。本研究旨在通过对哮喘患儿进行ENO水平和肺功能检测，并分析其相关性，探讨ENO监测在儿童哮喘控制评估中的临床价值。现报告如下。

1资料和方法

1.1一般资料

2013年1月至2015年4月都江堰市妇幼保健院儿科门诊就诊的哮喘患儿120例，均符合儿童哮喘诊断标准[2]。其中男68例，女52例。患儿年龄5～14岁，平均年龄(8.3±2.1)岁，反复喘息病史从3个月至5年不等，平均病史(2.6±0.9)年。所有患儿给予吸入性糖皮质激素及口服孟鲁司特钠治疗，4周后复诊行C-ACT评定。……