呼出气一氧化氮测定在毛细支气管炎远期转归中的临床意义研究

发布时间：2018-02-28 22:30

本文关键词： 呼出气一氧化氮(FeNO) 毛细支气管炎支气管哮喘　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过检测毛细支气管炎患儿过敏原特异性免疫球蛋白E(Specific immunoglobulin E,s Ig E)、血清总Ig E、外周血嗜酸性粒细胞(Eosinophils,EOS)计数、呼出气一氧化氮(Fraction exhaled nitric oxide,Fe NO)及日后反复喘息和哮喘的发生率,探讨Fe NO测定在毛细支气管炎患儿远期转归中的临床意义。方法:将符合毛细支气管炎入选标准的患儿,根据有无特应性体质分为特应性体质组和非特应性体质组。分别检测并记录两组患儿在急性期、治疗后1个月、3个月Fe NO、外周血EOS、血清总Ig E及随访6个月、12个月反复喘息和哮喘的发生率。结果:(1)无论是急性期、治疗后1个月及3个月的Fe NO、血清总Ig E及EOS特应性体质组均较非特应性体质组高,差异有统计学意义(P0.05)。(2)特应性体质组Fe NO、Ig E及EOS在治疗后1个月及3个月后与急性期相比,逐渐下降,差异有统计学意义(P0.05)。(3)非特应性体质组患儿的Fe NO、Ig E及EOS在治疗1月及3个月后与急性期相比,逐渐下降,差异有统计学意义(P0.05)。(4)在6个月、12个月的随访中,特应性体质组患儿在喘息次数及哮喘发生率均高于非特应性体质组,差异有统计学意义(P0.05)。(5)特应性体质组急性期Fe NO与6个月及12个月随访喘息次数成显著正相关(P0.01)。结论:(1)特应性体质组的毛细支气管炎患儿急性期、治疗后1个月及3个月的Fe NO、血清总Ig E及EOS均较非特应性体质组高,并且特应性体质组后期反复喘息的次数和发展为哮喘的可能性高于非特应性体质组,以上提示特应性体质是毛细支气管炎患儿日后反复喘息及发展为哮喘的高危因素。(2)Fe NO并不是在所有的毛细支气管炎患儿中都升高,特应性体质的毛细支气管炎患儿Fe NO与后期随访反复喘息次数成正相关,提示Fe NO可能成为预测毛细支气管炎患儿日后反复喘息和发展为哮喘的指标。
[Abstract]:Objective: to detect the count of allergen specific immunoglobulin (Ig E), serum total IgE, peripheral blood eosinophilic eosinophilus (EOS), exhale nitric oxide (no) fraction exhaled nitric oxide-iron (no), and the incidence of recurrent wheezing and asthma in children with bronchiolitis. To explore the clinical significance of determination of Fe no in the long term outcome of bronchiolitis in children. They were divided into atopic constitution group and non-atopic constitution group according to whether they had atopic constitution. One month, three months after treatment, FeNO, peripheral blood EOS, serum total IgE and the incidence of recurrent wheezing and asthma were observed for 6 months and 12 months after treatment. The serum levels of total IgE and EOS atopic constitution were significantly higher in 1 month and 3 months after treatment than those in non-atopic group, and the difference was statistically significant (P 0.05. 0. 0. 0. 2) FeNOIg E and EOS in the atopic constitution group were significantly higher than those in the acute phase 1 and 3 months after treatment. The levels of FeNOIg E and EOS in non-atopic physique group decreased gradually compared with those in acute stage in January and 3 months after treatment, and the difference was statistically significant (P 0.05) in 6 months and 12 months after treatment. The frequency of wheezing and the incidence of asthma in atopic constitution group were higher than those in non-atopic constitution group. There was a significant positive correlation between FeNO in the acute phase of atopic physique and the wheezing times in 6 months and 12 months follow-up. Conclusion the children in the atopic constitution group had acute bronchiolitis in the acute stage. At 1 month and 3 months after treatment, the levels of serum IgE and EOS were higher in the atopic group than in the non-atopic constitution group, and the frequency of repeated wheezing and the possibility of asthma development in the anaphase of the atopic constitution group were higher than those in the non-atopic constitution group. These results suggest that atopic constitution is a high risk factor for recurrent wheezing and asthma development in children with bronchiolitis, and that no does not increase in all children with bronchiolitis. FeNO in children with atopic bronchiolitis was positively correlated with the repeated wheezing times in the follow-up period, suggesting that FeNO might be a predictor of recurrent wheezing and asthma in children with bronchiolitis.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.6

【参考文献】