Objective To investigate the correlation of school-age children with asthma in different periods call outlet changes of fractional exhaled nitric oxide (FeNO), as well the pulmonary function and peripheral blood eosinophils eosino-phil. Methods Seventy-one cases of school age children with bronchial asthma were enrolled, 41 patients with acute episode as an acute attack period subgroup, 30 cases of chronic phase as chronic persistent subgroups, 26 cases of age matched healthy children as healthy control group. All enrolled children’ s FeNO concentration, routine pulmonary ventilation function and pe-ripheral blood eosinophil eosinophil were detected. Three groups of children’ s FeNO differences were compared, and the re-ceiver operating characteristic ( ROC) analysis were used to determine the optimal cutoff value of asthma; study of FeNO in asthmatic children and the maximum peak expiratory flow rate measured value was expected to account for a percentage of the value ( PEF% pred) , 75% forced expiratory flow rate measured value is expected to account for a percentage of the value of FEF75%pred, these indexes and peripheral blood eosinophils eosinophil percentage (EOS%) were analyzed. Results (1) Acute attack subgroup, chronic persistent period subgroup’s sensitivity was 0. 78, specificity was 0. 96. FeNO concentration in children patients were higher than those of healthy control group ( P <0. 05), acute attack subgroup’s FeNO concentration was higher than that of chronic persistent subgroups ( P <0. 05). The area under the ROC curve showed that the best value of FeNO for diagnosis of asthma was 26. 6ppb. (2) In patients with asthma acute attack period subgroup, lung function index PEF%pred, FEF75%pred were decreased, and FEF75%pred decreased more significantly; chronic duration subgroup com-pared with acute attack subgroup, index of pulmonary function were improved. Acute attack chronic subgroup, chronic persis-tent subgroup’s EOS% were higher than those in control group ( P <0. 05). (3) Asthma in different periods’ FeNO had no significant correlation (acute attack period subgroup:r = -0. 072, P =0. 653, r = -0. 194, P =0. 224;chronic period sub-group:r = -0. 193, P =0. 306, r =0. 253, P =0. 177);acute exacerbation and FeNO had weak correlation ( r =0. 389, P =0. 012), chronic persistent subgroup and healthy control group’ s FeNO EOS% had no significant correlation ( r =-0. 086, P =0. 653, r =0. 169, P =0. 409). Conclusion The FeNO can assist diagnosis of school-age children with asth-ma, as acute exacerbation of asthma risk or poor control performance index, but there are certain limitations. There was no significant correlation between FeNO and lung function, in the acute phase, had weak correlation with EOS%.%目的：探讨学龄期哮喘儿童不同时期呼出气一氧化氮( FeNO)的变化及其与肺功能、外周血嗜酸性粒细胞的相关性。方法学龄期支气管哮喘患儿71例,其中急性发作期41例作为急性发作期亚组,慢性持续期30例作为慢性持续期亚组,同龄健康体检儿童26例作为健康对照组,对所有入选儿童行 FeNO浓度、常规通气肺功能及外周血嗜酸性粒细胞检测。比较3组儿童FeNO的差异,并利用受试者工作特征( ROC)曲线分析 FeNO 诊断哮喘的最佳界值；探讨哮喘儿童FeNO与最大呼气峰流速实测值占预计值百分比( PEF%pred)、75%用力呼气流速实测值占预计值百分比(FEF75%pred)、外周血嗜酸性粒细胞百分比(EOS%)的相关性。结果(1)患儿FeNO浓度均高于健康对照组( P <0.05),急性发作期亚组FeNO 浓度高于慢性持续期亚组(均P <0.05)。 ROC曲线下面积显示FeNO诊断儿童哮喘的最佳界值为26.6ppb。敏感度为0.78,特异度为0.96。(2)哮喘患儿急性发作期亚组肺功能指标PEF%pred、FEF75%pred均有所下降,而以FEF75%pred下降更明显；慢性持续期亚组较急性发作期亚组的肺功能指标均有所好转。急性发作期亚组及慢性持续期亚组EOS%均高于健康对照组( P <0.05)。(3)哮喘不同时期FeNO与PEF%pred、FEF75%pred无明显相关性(急性发作期亚组：r =-0.072, P =0.653；r =-0.194, P =0.224；慢性持续期亚组：r =-0.193, P =0.306；r =0.253, P =0.177)；急性发作期亚组FeNO与EOS%有弱相关性( r =0.389, P =0.012),慢性持续期亚组、健康对照组 FeNO与 EOS%均无明显相关性( r =-0.086, P =0.653；r =0.169, P =0.409)。结论 FeNO 可协助学龄期儿童哮喘的诊断、作为哮喘急性发作风险或控制效果不佳的判断指标,但存在一定局限性。 FeNO与肺功能无明显相关性,在哮喘急性期与EOS%有弱相关性。
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