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目的探讨哮喘患儿呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)与其与外周血嗜酸性粒细胞(eosinophils,EOS)的相关性。了解FeNO及EOS在儿童哮喘中的临床意义,并为早期临床诊断和有效治疗提供依据。方法选取2012年7月-2013年12月在临朐县人民医院儿科病房及门诊确诊的哮喘患儿45例,正常对照组26例。分别测定FeNO及EOS的水平。结果 1)哮喘急性发作组FeNO[(57.34±41.53)ppb]、EOS水平[(1.66±4.52)×109/L]分别高于缓解组[(41.48±26.96)ppb],[(0.63±0.56)×109/L]和对照组[(16.14±6.37)ppb],[(0.08±0.07)×109/L],差异均有统计学意义(P<0.05);2)哮喘缓解组FeNO和EOS水平仍高于对照组,差异均有统计学意义(P<0.05);3)哮喘组患儿的FeNO水平与外周血EOS水平呈正相关(r=0.71,P<0.05)。结论哮喘患儿FeNO水平增高,与EOS有很好的相关性,其水平可以间接反映哮喘气道嗜酸性粒细胞性炎症,且敏感性较EOS更高。哮喘缓解期气道炎症仍存在,仍需抗炎治疗,临床上可联合应用FeNO和EOS来评估哮喘病情并调整治疗方案。
Objective To investigate the relationship between fractional exhaled nitric oxide (FeNO) and peripheral blood eosinophils (EOS) in children with asthma. To understand the clinical significance of FeNO and EOS in children with asthma and provide the basis for early clinical diagnosis and effective treatment. Methods Forty-five asthmatic children diagnosed in pediatric ward and outpatient department of Linyi County People’s Hospital from July 2012 to December 2013 were selected, and 26 normal control subjects were selected. The levels of FeNO and EOS were measured respectively. Results (1) The levels of FeNO (57.34 ± 41.53) ppb and EOS in acute exacerbation group were significantly higher than those in remission group [(41.48 ± 26.96) ppb] and (0.63 ± 0.56) (P <0.05); 2) The levels of FeNO and EOS in asthma remission group were significantly higher than those in control group [(16.14 ± 6.37) ppb], [(0.08 ± 0.07) × 109 / L] (P <0.05); 3) FeNO levels in children with asthma were positively correlated with EOS levels in peripheral blood (r = 0.71, P <0.05). Conclusions The level of FeNO in children with asthma is increased and has a good correlation with EOS. The level of FeNO may indirectly reflect asthmatic airway eosinophilic inflammation with a higher sensitivity than EOS. Asthma remission airway inflammation still exists, the need for anti-inflammatory treatment, clinical application of FeNO and EOS can be used to assess the assessment of asthma and treatment options.