CAJ | 학술논문

目的：探讨哮喘患儿呼出气一氧化氮（fractional exhaled nitric oxide，FeNO）在儿童哮喘管理中的作用。方法选取未规范治疗的哮喘患儿60例（哮喘组）和同期40例健康儿童（对照组）。哮喘组患儿给予6个月的沙美特罗氟替卡松气雾剂（Shah Mette Lo fluticasone propionate aerosol，商品名：舒利迭，50μg／100μg，bid）治疗，检测治疗前及治疗后6个月的 FeNO、血清嗜酸阳离子蛋白（eosinophile cationic protein，ECP）、血清总免疫球蛋白 E （total serum immunoglobulin E，IgE）及肺功能指标 FEVl占预计值百分比（FEVl％）。结果治疗前，哮喘组 Fe-NO、ECP及 IgE均明显高于对照组（均P＜0．01），FEVl％明显低于对照组（P＜0．01）。与治疗前比较：哮喘组治疗6个月后的 FeNO、ECP及 IgE显著降低（均P＜0．01），但仍高于对照组（均P＜0．01）；FEVl％水平明显升高（P＜0．01），但与对照组比较差异无统计学意义（P＞0．05）。治疗前哮喘组 FeNO与血清 ECP、IgE呈正相关（r＝0．850，P＝0．000；r＝0．689，P＝0．000），与 FEVl％无相关性（r＝－0．216，P＝0．097）。治疗6个月后，FeNO仍与血清 ECP呈正相关（r＝0．665，P＝0．000），而与 FEVl％、IgE 无相关性（r＝0．185，r＝0．226；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，有助于评估哮喘的控制情况。
목적：탐토효천환인호출기일양화담（fractional exhaled nitric oxide，FeNO）재인동효천관리중적작용。방법선취미규범치료적효천환인60례（효천조）화동기40례건강인동（대조조）。효천조환인급여6개월적사미특라불체잡송기무제（Shah Mette Lo fluticasone propionate aerosol，상품명：서리질，50μg／100μg，bid）치료，검측치료전급치료후6개월적 FeNO、혈청기산양리자단백（eosinophile cationic protein，ECP）、혈청총면역구단백 E （total serum immunoglobulin E，IgE）급폐공능지표 FEVl점예계치백분비（FEVl％）。결과치료전，효천조 Fe-NO、ECP급 IgE균명현고우대조조（균P＜0．01），FEVl％명현저우대조조（P＜0．01）。여치료전비교：효천조치료6개월후적 FeNO、ECP급 IgE현저강저（균P＜0．01），단잉고우대조조（균P＜0．01）；FEVl％수평명현승고（P＜0．01），단여대조조비교차이무통계학의의（P＞0．05）。치료전효천조 FeNO여혈청 ECP、IgE정정상관（r＝0．850，P＝0．000；r＝0．689，P＝0．000），여 FEVl％무상관성（r＝－0．216，P＝0．097）。치료6개월후，FeNO잉여혈청 ECP정정상관（r＝0．665，P＝0．000），이여 FEVl％、IgE 무상관성（r＝0．185，r＝0．226；P＞0．05）。결론FeNO시일충교이상적반영기도기산성염증적생물학지표，유조우평고효천적공제정황。
ABSTRACT:Objective To discuss the application of fractional exhaled nitric oxide(FeNO)in the management of childhood asthma.Methods Sixty asthmatic children without standard medication treat-ment were treated with Shah Mette Lo fluticasone propionate aerosol(Seretide,50μg/100μg,bid).In addition,40 healthy children were recruited as controls.The FeNO,serum eosinophil cationic pro-tein(ECP),total serum immunoglobulin E(IgE)and forced expiratory volume in one second(FE-Vl)percent predicted (FEVl%)were determined before and after treatment for 6 months.Results Compared with control group,levels of FeNO,ECP and IgE increased before and after treat-ment but FEVl% decreased before treatment in asthmatic group(P<0.01).After treatment for 6 months,levels of FeNO,ECP and IgE decreased but FEVl% increased in asthmatic group (P<0.01).There was no significant difference in FEVl% between the two groups after treatment (P>0.05).Before treatment,FeNO levels were positively correlated with ECP levels(r=0.850, P=0.000)and IgE levels(r=0.689,P=0.000),but were not correlated with FEVl%(r=-0.216,P=0.097)in children with asthma.After treatment for 6 months,FeNO levels were still positively correlated with ECP levels(r=0.665,P=0.000),but were not correlated with FE-Vl%、IgE(r=0.185,r=0.266;P<0.05)in children with asthma.Conclusion FeNO is an ideal biological indicator reflecting eosinophilic airway inflammation,which can help to assess the con-trol of asthma.