CAJ | 학술논문

目的：通过探讨呼出气一氧化氮（FeNO）水平、分泌型免疫球蛋白E（sIgE）、外周血嗜酸性粒细胞（EOS）和第1秒用力肺活量占预计值百分比（FEV1%）的相关性，以观察婴幼儿喘息患儿是否存在肺通气功能障碍和气道慢性炎性反应，以期深入了解婴幼儿喘息与哮喘之间的相关性。方法选择2014年1~10月该院儿科病房住院的年龄4~5岁同期住院确诊为婴幼儿喘息患儿共123例，其中确诊为婴幼儿哮喘的82例为哮喘组，支气管肺炎41例为肺炎组，另选择择期手术患儿40例为对照组。对哮喘组再分为急性期（治疗前）、缓解期（治疗12周后），分别测定各组FeNO、EOS、sIgE及FEV1%水平，并进行统计学分析。结果（1）哮喘组急性期FeNO[（55.42±6.12）×10-9 mmol/L]、EOS[（2.48±0.41）×109 L-1]、sIgE[（17.25±0.93）U/mL]分别高于哮喘组缓解期[（22.33±1.29）×10-9 mmol/L、（0.61±0.12）×109 L-1、（1.45±0.61）U/mL]、肺炎组[（10.76±0.49）×10-9 mmol/L、（0.09±0.05）×109 L-1、（0.14±0.17）U/mL]和对照组[（10.74±0.46）×10-9 mmol/L、（0.09±0.07）×109 L-1、（0.17±0.11）U/mL]；FEV1%[（70.41±2.91）%]低于哮喘组缓解期[（91.30±1.84）%]、肺炎组[（90.66±1.25）%]和对照组[（92.08±1.05）%]，差异均有统计学意义（P＜0.05）。（2）哮喘组缓解期FeNO、EOS水平及sIgE仍高于肺炎组，差异均有统计学意义（P＜0.05）；而两组FEV1%比较，差异无统计学意义（P＞0.05）。（3）哮喘组缓解期FeNO、EOS水平及sIgE仍高于对照组，差异均有统计学意义（P＜0.05），而两组FEV1%比较，差异无统计学意义（P＞0.05）。（4）肺炎组FeNO、EOS、sIgE及FEV1%与对照组比较，差异无统计学意义（P＞0.05）。（5）哮喘患儿FeNO水平与EOS、sIgE呈正相关（r=0.71，P＜0.05），FeNO水平与FEV1%、EOS与FEV1%、sIgE与FEV1%均无明显相关性（r=-0.14、-0.06、-0.09，P＞0.05）。结论哮喘患儿的FeNO水平可反映哮喘气道嗜酸性粒细胞性炎症，且敏感性较sIgE和EOS更高。哮喘患儿中FeNO水平与sIgE、EOS有很好的相关性。FeNO、sIgE及EOS可用于协助鉴别过敏性炎症和普通感染，评估哮喘病情及调整治疗方案。目的：通過探討呼齣氣一氧化氮（FeNO）水平、分泌型免疫毬蛋白E（sIgE）、外週血嗜痠性粒細胞（EOS）和第1秒用力肺活量佔預計值百分比（FEV1%）的相關性，以觀察嬰幼兒喘息患兒是否存在肺通氣功能障礙和氣道慢性炎性反應，以期深入瞭解嬰幼兒喘息與哮喘之間的相關性。方法選擇2014年1~10月該院兒科病房住院的年齡4~5歲同期住院確診為嬰幼兒喘息患兒共123例，其中確診為嬰幼兒哮喘的82例為哮喘組，支氣管肺炎41例為肺炎組，另選擇擇期手術患兒40例為對照組。對哮喘組再分為急性期（治療前）、緩解期（治療12週後），分彆測定各組FeNO、EOS、sIgE及FEV1%水平，併進行統計學分析。結果（1）哮喘組急性期FeNO[（55.42±6.12）×10-9 mmol/L]、EOS[（2.48±0.41）×109 L-1]、sIgE[（17.25±0.93）U/mL]分彆高于哮喘組緩解期[（22.33±1.29）×10-9 mmol/L、（0.61±0.12）×109 L-1、（1.45±0.61）U/mL]、肺炎組[（10.76±0.49）×10-9 mmol/L、（0.09±0.05）×109 L-1、（0.14±0.17）U/mL]和對照組[（10.74±0.46）×10-9 mmol/L、（0.09±0.07）×109 L-1、（0.17±0.11）U/mL]；FEV1%[（70.41±2.91）%]低于哮喘組緩解期[（91.30±1.84）%]、肺炎組[（90.66±1.25）%]和對照組[（92.08±1.05）%]，差異均有統計學意義（P＜0.05）。（2）哮喘組緩解期FeNO、EOS水平及sIgE仍高于肺炎組，差異均有統計學意義（P＜0.05）；而兩組FEV1%比較，差異無統計學意義（P＞0.05）。（3）哮喘組緩解期FeNO、EOS水平及sIgE仍高于對照組，差異均有統計學意義（P＜0.05），而兩組FEV1%比較，差異無統計學意義（P＞0.05）。（4）肺炎組FeNO、EOS、sIgE及FEV1%與對照組比較，差異無統計學意義（P＞0.05）。（5）哮喘患兒FeNO水平與EOS、sIgE呈正相關（r=0.71，P＜0.05），FeNO水平與FEV1%、EOS與FEV1%、sIgE與FEV1%均無明顯相關性（r=-0.14、-0.06、-0.09，P＞0.05）。結論哮喘患兒的FeNO水平可反映哮喘氣道嗜痠性粒細胞性炎癥，且敏感性較sIgE和EOS更高。哮喘患兒中FeNO水平與sIgE、EOS有很好的相關性。FeNO、sIgE及EOS可用于協助鑒彆過敏性炎癥和普通感染，評估哮喘病情及調整治療方案。
목적：통과탐토호출기일양화담（FeNO）수평、분비형면역구단백E（sIgE）、외주혈기산성립세포（EOS）화제1초용력폐활량점예계치백분비（FEV1%）적상관성，이관찰영유인천식환인시부존재폐통기공능장애화기도만성염성반응，이기심입료해영유인천식여효천지간적상관성。방법선택2014년1~10월해원인과병방주원적년령4~5세동기주원학진위영유인천식환인공123례，기중학진위영유인효천적82례위효천조，지기관폐염41례위폐염조，령선택택기수술환인40례위대조조。대효천조재분위급성기（치료전）、완해기（치료12주후），분별측정각조FeNO、EOS、sIgE급FEV1%수평，병진행통계학분석。결과（1）효천조급성기FeNO[（55.42±6.12）×10-9 mmol/L]、EOS[（2.48±0.41）×109 L-1]、sIgE[（17.25±0.93）U/mL]분별고우효천조완해기[（22.33±1.29）×10-9 mmol/L、（0.61±0.12）×109 L-1、（1.45±0.61）U/mL]、폐염조[（10.76±0.49）×10-9 mmol/L、（0.09±0.05）×109 L-1、（0.14±0.17）U/mL]화대조조[（10.74±0.46）×10-9 mmol/L、（0.09±0.07）×109 L-1、（0.17±0.11）U/mL]；FEV1%[（70.41±2.91）%]저우효천조완해기[（91.30±1.84）%]、폐염조[（90.66±1.25）%]화대조조[（92.08±1.05）%]，차이균유통계학의의（P＜0.05）。（2）효천조완해기FeNO、EOS수평급sIgE잉고우폐염조，차이균유통계학의의（P＜0.05）；이량조FEV1%비교，차이무통계학의의（P＞0.05）。（3）효천조완해기FeNO、EOS수평급sIgE잉고우대조조，차이균유통계학의의（P＜0.05），이량조FEV1%비교，차이무통계학의의（P＞0.05）。（4）폐염조FeNO、EOS、sIgE급FEV1%여대조조비교，차이무통계학의의（P＞0.05）。（5）효천환인FeNO수평여EOS、sIgE정정상관（r=0.71，P＜0.05），FeNO수평여FEV1%、EOS여FEV1%、sIgE여FEV1%균무명현상관성（r=-0.14、-0.06、-0.09，P＞0.05）。결론효천환인적FeNO수평가반영효천기도기산성립세포성염증，차민감성교sIgE화EOS경고。효천환인중FeNO수평여sIgE、EOS유흔호적상관성。FeNO、sIgE급EOS가용우협조감별과민성염증화보통감염，평고효천병정급조정치료방안。
Objective To observe whether the children patients exist lung ventilation dysfunction and chronic airway in-flammation and investigate the correlation between the infant asthma and asthma by fractional exhaled nitric oxide (FeNO) concen-trations,secretory immanoglobulinE(sIgE),peripheral blood eosinophils(EOS) and pulmonary function test(FEV1%). Methods A total of 123 children patients confirmed as infant asthma aged 4-5 years old in the ward of department of pediatrics of this hospital from January to October in 2014 were selected including the asthma group with 82 cases diagnosed as infant asthma , the pneumonia group with 41 cases as bronchial pneumonia and the control group with 40 healthy cases ,in which,the asthma group was divided into the acute stage(before the treatment),the remission stage(after the treatment for 12 weeks). FeNO,EOS,sIgE and FEV1%of each group were measured finally and then the figures were statistically analyzed. Results (1)FeNO(55.42± 6.12)×10-9 mmol/L,EOS(2.48±0.41)×109 L-1,sIgE(17.25±0.93)U/mL of the asthma group in the acute period were higher than those of the remission period[(22.33±1.29)×10-9 mmol/L,(0.61±0.12)×109 L-1,(1.45±0.61)U/mL,the pneumonia group[(10.76± 0.49)×10-9 mmol/L,(0.09±0.05)×109 L-1,(0.14±0.17)U/mL] and the control group[(10.74±0.46)×10-9 mmol/L,(0.09±0.07)×109 L-1, (0.17±0.11)U/mL]. FEV1%level(70.41±2.91)%was lower than the remission group(91.30±1.84)%,the pneumonia group(90.66± 1.25)%and the control group (92.08±1.05)%,all of which had statistical significance in difference (P<0.05). (2)FeNO,EOS and sIgE levels of the asthma group at the remission stage were still higher than those of the pneumonia group ,and the difference had statistical significance(P<0.05). But the difference of FEV1%concentration between the two groups was not statistically significant (P>0.05).(3)FeNO,EOS and sIgE levels of the asthma group at the remission stage were still higher than those of the control group,the difference were statistically significant(P<0.05),while the difference of FEV1%concentration between the two groups was not statistically significant(P>0.05).(4)The pneumonia group had no statistical significance in FeNO,EOS,sIgE and FEV1%concentration compared with control group(P>0.05).(5)FeNO level of children patients with asthma was positively correlated with the EOS,sIgE(r=0.71,P<0.05),FeNO concentration,EOS and sIgE showed no significant correlation with FEV1%(r=-0.14,-0.06,-0.09,P>0.05). Conclusions The FeNO concentration of children patients with asthma may reflect the eosinophil inflammation of asthma airway,whose sensitivity is higher than sIgE and EOS. For patients with asthma,FeNO has a good correlation with sIgE and EOS. FeNO,sIgE and EOS may be applied to help identify allergic inflammation and common infections ,assessing asthma condition and adjusting the treatment schedule.