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目的探究呼出气一氧化氮(FeNO)在小儿支气管哮喘诊断、治疗效果和病情监测中的价值。方法回顾分析自2015年10月至2016年5月在广东省江门市妇幼保健计划生育服务中心就诊的47例小儿支气管哮喘患者的资料,根据患者的哮喘类型,将患者分为典型哮喘组和变异哮喘组,另将同期在该中心接受体检的健康儿童29例纳入对照组。对所有受试者进行FeNO和肺功能检测。所有哮喘患儿在治疗3个月后再次进行FeNO和肺功能检测,同时采用哮喘控制测试量表(AST)对患者的既往病情控制进行评估。比较三组患者的FeNO和一秒钟用力呼气量与用力肺活量比值(FEV_1%),哮喘患儿治疗前后的FeNO和FEV_1%。根据AST评分比较不同病情控制程度的哮喘患儿FeNO和FEV_1%水平。结果三组初始的FeNO和FEV_1%比较,差异有统计学意义(P均<0.01),而两组哮喘患儿FeNO和FEV_1%比较,差异均无统计学意义(P均>0.05)。两组患者接受治疗后FeNO和FEV_1%与治疗前相比,差异有统计学意义(P<0.05),但治疗后两组哮喘患儿FeNO和FEV_1%比较,差异均无统计学意义(P>0.05)。两组患儿规范治疗3个月后不同ACT等级的哮喘患儿的FeNO和FEV_1%水平差异有统计学意义(P<0.05,P<0.01)。结论 FeNO检测可以作为一项有效的、非创伤性的检测手段,对小儿支气管哮喘的诊断、治疗效果以及病情监测等提供一定的帮助。
Objective To investigate the value of exhaled nitric oxide (FeNO) in the diagnosis, treatment and monitoring of bronchial asthma in children. Methods The data of 47 pediatric patients with bronchial asthma who were treated at the MCH family planning service center of Jiangmen City, Guangdong Province from October 2015 to May 2016 were retrospectively analyzed. According to the type of asthma, the patients were divided into typical asthma group and mutation In the asthma group, 29 healthy children undergoing physical examination during the same period were included in the control group. FeNO and lung function tests were performed on all subjects. All children with asthma were retested for FeNO and lung function 3 months after treatment, and the patient’s past condition was assessed using the Asthma Control Test Scale (AST). The FeNO and forced expiratory volume to forced vital capacity (FEV_1%) were compared between the three groups. The FeNO and FEV_1% before and after treatment of asthmatic children were compared. The levels of FeNO and FEV_1% in children with asthma were compared according to the AST score. Results The initial FeNO and FEV_1% of three groups were statistically significant (P <0.01). There was no significant difference in FeNO and FEV_1% between the two groups (P> 0.05). FeNO and FEV_1% after treatment were significantly different from those before treatment (P <0.05), but there was no significant difference in FeNO and FEV_1% between the two groups after treatment (P> 0.05). The FeNO and FEV_1% levels of asthmatic children with different ACT grades after 3 months of treatment were statistically significant (P <0.05, P <0.01). Conclusion FeNO can be used as an effective and non-invasive means to diagnose and treat bronchial asthma in children.