中国医药
中國醫藥
중국의약
CHINA MEDICINE
2015年
6期
812-815
,共4页
顾剑华%金晓群%徐艳娜%李永莲%桂丽琼%金殊
顧劍華%金曉群%徐豔娜%李永蓮%桂麗瓊%金殊
고검화%금효군%서염나%리영련%계려경%금수
呼出气一氧化氮%哮喘%儿童
呼齣氣一氧化氮%哮喘%兒童
호출기일양화담%효천%인동
Fractional exhaled nitric oxide%Asthma%Children
目的 评价呼出气一氧化氮(FeNO)检测在儿童哮喘管理中的价值.方法 选取未规范治疗的哮喘患儿60例(哮喘组),给予沙美特罗氟替卡松气雾剂(舒利迭,每揿含50μg沙美特罗和100μg氟替卡松,2次/d)治疗6个月,检测治疗前及治疗后1、3、6个月的FeNO、血清嗜酸粒细胞阳离子蛋白(ECP)、第1秒用力肺活量占预计值百分比(FEV1％),进行哮喘控制测试问卷(ACT)评分.同期选取40例非呼吸道疾病患儿为对照组,检测FeNO、ECP及FEV1％.比较2组患儿FeNO、ECP、FEV1％水平差异.结果 治疗前哮喘组FeNO、ECP水平明显高于对照组[FeNO:(53±27) μg/L比(10±5) μg/L,ECP:(21.6±3.0)μg/L比(4.9±1.2)μg/L,FEV1％明显低于对照组[(79±21)％比(98±8)％],差异均有统计学意义(均P＜0.05).与治疗前比较,哮喘组治疗后1、3、6个月FeNO、ECP明显降低,FEV1％及ACT评分明显升高[FeNO:(33±19)、(23±14)、(21±10) μg/L比(53 ±27)μg/L,ECP:(16.0±3.3)、(9.4±3.2)、(7.2±2.0)μg/L比(21.6±3.0)μg/L,FEV1％:(91±12)％、(96±12)％、(99±10)％比(79±21)％,ACT评分:(22.7±3.8)、(25.4±2.2)、(26.2±1.6)分比(17.6±3.3)分],差异有统计学意义(P＜0.01).治疗前哮喘组FeNO与ECP呈正相关(r=0.850,P＜0.01),与ACT评分呈负相关(r=-0.728,P＜0.01),与FEV1无相关性(r=-0.216,P＞0.05).治疗1、3、6个月后,哮喘组FeNO与ECP仍呈正相关(r =0.695,P＜0.01;r=0.624,P＜0.01;r=0.665,P＜0.01),与FEV1及ACT评分均无相关性(均P＞0.05).结论 FeNO是一种较理想的反映气道嗜酸性炎症的生物学指标,其检测有助于评估哮喘的控制情况.
目的 評價呼齣氣一氧化氮(FeNO)檢測在兒童哮喘管理中的價值.方法 選取未規範治療的哮喘患兒60例(哮喘組),給予沙美特囉氟替卡鬆氣霧劑(舒利迭,每撳含50μg沙美特囉和100μg氟替卡鬆,2次/d)治療6箇月,檢測治療前及治療後1、3、6箇月的FeNO、血清嗜痠粒細胞暘離子蛋白(ECP)、第1秒用力肺活量佔預計值百分比(FEV1％),進行哮喘控製測試問捲(ACT)評分.同期選取40例非呼吸道疾病患兒為對照組,檢測FeNO、ECP及FEV1％.比較2組患兒FeNO、ECP、FEV1％水平差異.結果 治療前哮喘組FeNO、ECP水平明顯高于對照組[FeNO:(53±27) μg/L比(10±5) μg/L,ECP:(21.6±3.0)μg/L比(4.9±1.2)μg/L,FEV1％明顯低于對照組[(79±21)％比(98±8)％],差異均有統計學意義(均P＜0.05).與治療前比較,哮喘組治療後1、3、6箇月FeNO、ECP明顯降低,FEV1％及ACT評分明顯升高[FeNO:(33±19)、(23±14)、(21±10) μg/L比(53 ±27)μg/L,ECP:(16.0±3.3)、(9.4±3.2)、(7.2±2.0)μg/L比(21.6±3.0)μg/L,FEV1％:(91±12)％、(96±12)％、(99±10)％比(79±21)％,ACT評分:(22.7±3.8)、(25.4±2.2)、(26.2±1.6)分比(17.6±3.3)分],差異有統計學意義(P＜0.01).治療前哮喘組FeNO與ECP呈正相關(r=0.850,P＜0.01),與ACT評分呈負相關(r=-0.728,P＜0.01),與FEV1無相關性(r=-0.216,P＞0.05).治療1、3、6箇月後,哮喘組FeNO與ECP仍呈正相關(r =0.695,P＜0.01;r=0.624,P＜0.01;r=0.665,P＜0.01),與FEV1及ACT評分均無相關性(均P＞0.05).結論 FeNO是一種較理想的反映氣道嗜痠性炎癥的生物學指標,其檢測有助于評估哮喘的控製情況.
목적 평개호출기일양화담(FeNO)검측재인동효천관리중적개치.방법 선취미규범치료적효천환인60례(효천조),급여사미특라불체잡송기무제(서리질,매흠함50μg사미특라화100μg불체잡송,2차/d)치료6개월,검측치료전급치료후1、3、6개월적FeNO、혈청기산립세포양리자단백(ECP)、제1초용력폐활량점예계치백분비(FEV1％),진행효천공제측시문권(ACT)평분.동기선취40례비호흡도질병환인위대조조,검측FeNO、ECP급FEV1％.비교2조환인FeNO、ECP、FEV1％수평차이.결과 치료전효천조FeNO、ECP수평명현고우대조조[FeNO:(53±27) μg/L비(10±5) μg/L,ECP:(21.6±3.0)μg/L비(4.9±1.2)μg/L,FEV1％명현저우대조조[(79±21)％비(98±8)％],차이균유통계학의의(균P＜0.05).여치료전비교,효천조치료후1、3、6개월FeNO、ECP명현강저,FEV1％급ACT평분명현승고[FeNO:(33±19)、(23±14)、(21±10) μg/L비(53 ±27)μg/L,ECP:(16.0±3.3)、(9.4±3.2)、(7.2±2.0)μg/L비(21.6±3.0)μg/L,FEV1％:(91±12)％、(96±12)％、(99±10)％비(79±21)％,ACT평분:(22.7±3.8)、(25.4±2.2)、(26.2±1.6)분비(17.6±3.3)분],차이유통계학의의(P＜0.01).치료전효천조FeNO여ECP정정상관(r=0.850,P＜0.01),여ACT평분정부상관(r=-0.728,P＜0.01),여FEV1무상관성(r=-0.216,P＞0.05).치료1、3、6개월후,효천조FeNO여ECP잉정정상관(r =0.695,P＜0.01;r=0.624,P＜0.01;r=0.665,P＜0.01),여FEV1급ACT평분균무상관성(균P＞0.05).결론 FeNO시일충교이상적반영기도기산성염증적생물학지표,기검측유조우평고효천적공제정황.
Objective To evaluate the value of fractional exhaled nitric oxide (FeNO) in the management of childhood asthma.Methods Totally 60 cases of asthmatic children without standard medication treatment (asthmatic group) and 40 non respiratory children (control group) were recruited.Asthmatic group was administrated with Shah Mette Lo fluticasone propionate aerosol (50 μg Shah Mette Lo and 100 μg fluticasone/press,2 times/d) for 6 months.The FeNO,serum eosinophil cationic protein (ECP),lung function (FEV1 ％) and asthma control test (ACT) were determined and compared between the two groups before and 1,3 and 6 month after treatment.Results Before treatment,the FeNO,ECP were significantly higher and FEV1％ were significantly lower in asthmatic group compared with those in control group [(53 ± 27) μg/L vs (10 ± 5) μg/L,(21.6 ± 3.0) μg/L vs (4.9 ±1.2) μg/L,(79 ±21)％ vs (98 ±8)％,P＜0.05].In asthmatic group,the FeNO and ECP were significantly reduced,the FEV1 ％ and ACT score were significantly increased 1,3 and 6 months after treatment compared with those before treatment [(33 ± 19),(23 ± 14),(21 ± 10) μg/L vs (53 ± 27) μg/L,(16.0±3.3),(9.4±3.2),(7.2±2.0) μg/L vs (21.6±3.0) μg/L,(91 ±12)％,(96±12)％,(99±10)％ vs (79±21)％,(22.7±3.8),(25.4±2.2),(26.2±1.6) scores vs (17.6±3.3) scores] (P＜0.01).In asthma group,the FeNO level was positively correlated with ECP level (r =0.850,P ＜0.01);it was negatively correlated with ACT score (r =-0.728,P ＜ 0.01) and was not correlated with FEV1 ％ (r =-0.216,P =0.097) before treatment.After 1,3 and 6 months of treatment,the FeNO level was still positively correlated with ECP (r =0.695,P ＜0.01;r =0.624,P ＜0.01;r =0.665,P ＜0.01),but it showed no significant correlation with FEV1 ％ and ACT score(all P ＞ 0.05).Conclusion FeNO is an ideal biological indicator for eosinophilic airway inflammation,which is helpful for assessing the controlling station of asthma.
