呼出气一氧化氮检测在儿童咳嗽变异性哮喘诊治中的价值

摘要

目的 探讨呼出气一氧化氮(FeNO)在儿童咳嗽变异性哮喘(CVA)诊断和治疗中的价值.方法 选取CVA患儿75例(CVA组)、健康儿童25例(对照组)作为研究对象.对比对照组儿童及CVA组患儿治疗前后的FeNO水平及肺功能,对CVA组患儿进行过敏原皮肤点刺试验评估特异质情况,分析CVA患儿特异质严重程度与FeNO水平的相关性.结果 治疗前,CVA组的FeNO水平高于治疗后水平和对照组(P<0.05),第 1秒最大呼气量及最大呼气中期流量占预计值百分比均低于治疗后水平和对照组(P<0.05).过敏原皮肤点刺试验呈特异质共55例(73.3%),非特异质共20例(26.7%).治疗前,特异质CVA患儿的FeNO水平高于非特异质CVA患儿(P<0.05),CVA患儿特异质严重程度与FeNO水平呈正相关(P<0.05).结论 FeNO水平与CVA患儿的特异质及其严重程度关系密切,FeNO水平检测有助于儿童CVA的诊断及治疗效果评估.%Objective To explore the value of fractional exhaled nitric oxide(FeNO) in the diagnosis and treatment of pediatric cough variant asthma(CVA).Methods A total of 75 children with CVA and 25 healthy children were enrolled as CVA group and control group respectively.The FeNO level and lung function were compared between the control group and CVA group before and after treatment.Skin prick allergy test was performed in the CVA group for the evaluation of atopy.The correlation between the severity of atopy and FeNO level was analyzed in the children with CVA.Results The FeNO level of the CVA group before treatment was higher than the level after treatment and the level of the control group(P<0.05).Before treatment,the ratio of forced expiratory volume in one second to predicted value and the ratio of maximum mid-expiratory flow to predicted value of the CVA group were lower than those after treatment and those of the control group(P<0.05).The result of skin prick allergy test showed that atopy was found in 55 cases(73.3%) and non-atopy in 20 cases(26.7%).Before treatment,the FeNO level of the CVA children with atopy was higher than that of the CVA children without atopy(P<0.05),and the severity of atopy positively correlated with the FeNO level in the children with CVA(P<0.05).Conclusion The FeNO level closely correlates with atopy and its severity of the children with CVA.The detection of FeNO level might contribute to the diagnosis and efficacy assessment of children with CVA.