中国实用儿科杂志 ›› 2011, Vol. 26 ›› Issue (8): 596-.

• 论著 • 上一篇    下一篇

呼出气一氧化氮监测对儿童哮喘治疗指导作用的前瞻性研究

  

  1. 深圳市儿童医院呼吸内科,广东深圳 518026
  • 收稿日期:2011-03-05 修回日期:2011-05-29 出版日期:2011-08-06 发布日期:2011-09-19
  • 基金资助:

    深圳市科技计划项目(医疗卫生类)(200903094)

Prospective study on monitoring of exhaled nitric oxide in the management of childhood asthma.

  1. Shenzhen Children’s Hospital, Shenzhen, Guangdong 518026,China
  • Received:2011-03-05 Revised:2011-05-29 Online:2011-08-06 Published:2011-09-19

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

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