特异质与慢性持续期哮喘儿童呼出气一氧化氮相关性研究

摘要

Objective To evaluate the influence of atopy on exhaled nitric oxide in chronic persistent asthmatic children. Methods A total of 52 chronic persistent asthmatic children who completed FeNO measurements and skin prick testing were enrolled. Patients were divided into non-atopic group and atopic group by skin prick testing results, and subdivided into non-allergic rhinitis and rhinitis group according to whether combined with allergic rhinitis. At the same time 78 healthy children were chosen as control group. Moreover, 32 chronic persistent asthmatic children who completed FeNO measurements twice interval of three months were enrolled. Results The FeNO level was signiifcantly different among the atopic group (n=40), the non-atopic group (n=12) and the control group (H=33.29, P=0.000);The FeNO level was signiifcantly higher in the atopic group than that in the non-atopic group (P<0.05). And the FeNO level were signiifcantly different among the rhinitis group (n=41), the non-rhinitis group (n=11) and the control group (H=30.63, P=0.000). The FeNO level was signiifcantly higher in the rhinitis group than that in the control group (P<0.05), however there were no difference between the rhinitis group and the non-rhinitis group(P>0.05).There were no correlations between FeNO levels of chronic persistent asthmatic children and the wheal diameter of house dust mites or dust mites (r=2.05, P=0.135;r=1.58, P=0.312). Moreover, the FeNO level was signiifcantly lower after 3 months ICS treatment (z=-2.05, P=0.041). Conclusions Atopy had major inlfuence on the FeNO level of chronic persistent asthmatic children, and the FeNO level declined with the theatment of ICS.%目的：评估特异质对慢性持续期哮喘儿童呼出气一氧化氮(FeNO)水平的影响。方法选取同时完成皮肤点刺试验和FeNO 检测的慢性持续期哮喘患儿52例，按皮肤点刺试验结果分为非特异质组和特异质组，按有无合并过敏性鼻炎分为鼻炎组和无鼻炎组；另选择78例健康儿童作为对照组，比较各组FeNO水平；并比较32例予吸入型糖皮质激素治疗3个月患儿的FeNO水平变化。结果40例特异质组、12例非特异质组和对照组的FeNO水平差异有统计学意义(H=33.29，P=0.000)；特异质组FeNO水平高于对照组和非特异质组，差异有统计学意义(P<0.05)。11例无鼻炎组、41例鼻炎组和对照组的FeNO水平差异有统计学意义(H=30.63，P=0.000)；鼻炎组FeNO水平高于对照组，差异有统计学意义(P<0.05)；鼻炎组与无鼻炎组差异无统计学意义(P>0.05)。特异质组患儿FeNO水平与屋尘螨、粉尘螨皮肤点刺致敏风团直径无相关性(r=2.05、1.58，P均>0.05)。32例患儿经吸入糖皮质激素治疗3个月后FeNO水平显著下降，与其治疗前第一次检测结果比较，差异有统计学意义(Z=2.05，P=0.041)。结论特异质对慢性持续期哮喘儿童FeNO水平有重要影响，吸入糖皮质激素可显著降低致敏哮喘儿童FeNO水平。