Abstract:

Abstract：Object　To evaluate the role of FeNo monitoring in the management of asthma. Methods　After 10 months of treatment，the symptoms. Forty-one children with asthma were allocated to a FeNO group （n = 20） and to a control group （n = 21）. β-agonist use， lung function，and FeNO were studied. Results　After 10-months therapy， frequency of respiratory symptoms， β-agonist use，FEV1%Ppredicted， MEF50%predictted and the frequency of exacerbations were similar between two groups. Patients in the FeNO group received higher doses of inhaled corticosteroids（ICS）（ FeNO group：290±75， control group：225±50），with statistically significant difference. Conclusion　We could not demonstrate a clinical benefit of including FeNO into asthma monitoring in asthma children on inhaled steroid. A longer follow-up might be necessary to demonstrate improved outcome.

Key words: airway inflammation, child asthma；fractional exhaled nitric oxide, inhaled corticosteroids

摘要：

目的　评价呼出气一氧化氮（FeNO）监测在哮喘控制治疗中的评估指导作用。方法　收集深圳市儿童医院哮喘专科门诊的41例患儿，根据抽签分组，20例进入FeNO组，21例进入对照组。控制治疗中，对照组根据儿童哮喘控制水平分级进行调整；FeNO组在此基础上结合FeNO检测结果进行调整。在10个月治疗后，观察两组之间哮喘症状、短效β受体激动剂使用情况、肺功能结果，吸入激素使用量，从而判断FeNO检测在哮喘控制治疗中的作用。结果　FeNO组使用短效β受体激动剂平均天数为（4.3±3）d，对照组为（3.7±2.8）d ；FeNO组总发作次数9次，对照组为11次；第1秒用力呼气容积（FEV1）占预计值%在FeNO组为100.96±7.69，对照组为90.37±12.95；达50％用力肺活量时最大呼气流速（MEF50）占预计值% 在FeNO组为95.77±9.32，对照组为87.01±13.84。以上指标比较均为P > 0.05，差异无统计学意义。FeNO组平均吸入糖皮质激素量为（290±75）μg，对照组为（225±50）μg（P < 0.01）。结论　在哮喘控制治疗评估中，加入FeNO浓度检测，对吸入糖皮质激素（ICS）有指导作用，但未能显示出其临床上的优势。

关键词: 气道炎症, 儿童哮喘, 呼出气一氧化氮, 吸入糖皮质激素