呼出气一氧化氮与儿童哮喘病情相关性研究

发布时间：2018-06-09 01:03

本文选题：呼出气一氧化氮 + 哮喘　；参考：《上海交通大学》2014年硕士论文

【摘要】：第一部分：呼出气一氧化氮影响因素分析目的：呼出气一氧化氮（FeNO）可用于检测哮喘的气道炎症，本研究旨在探讨FeNO对于儿童哮喘诊断的应用价值，并对其影响因素进行分析。方法：收集2012年6月份至2013年6月份来我院就诊的哮喘患儿1068例和健康对照患儿210例，进行相关病史的采集、FeNO检测，，应用两独立样本t检验分析法比较哮喘患儿及健康对照患儿间FeNO值的差异，并应用一元线性相关与回归相关分析法分析FeNO值与哮喘影响因素的相关性。结果：（1）哮喘儿童FeNO值为（24.74±22.72）PPB，健康对照组FeNO值平均为（11.88±8.25）PPB，哮喘儿童的FeNo值较健康对照儿童显著升高（P0.05）。（2）哮喘及健康对照儿童的FeNO值均与年龄、体重、身高、体表面积呈正相关，但与湿疹等皮肤过敏史、其他系统疾病过敏史、家族过敏史无相关性；其中哮喘儿童的FeNO值与变应性鼻炎史、现存变应性鼻炎、长期控制用药相关。（3）哮喘儿童的FeNO值与一周内激素及孟鲁斯特钠的使用、哮喘外其他现存过敏性疾病无相关性。结论：哮喘儿童的FeNO值显著高于健康对照儿童，并与年龄、身高、体重、变应性鼻炎存在相关性，可作为诊断哮喘的参考依据。第二部分：呼出气一氧化氮与病情及哮喘亚型的相关性研究目的：本研究旨在探讨呼出气一氧化氮（FeNO）与儿童哮喘的亚型及病情的相关性。方法：选取2012年6月份至2013年9月份我院门诊3岁到14岁确诊为哮喘患儿共计1068例，根据哮喘亚型分为哮喘组、咳嗽变异性哮喘组。根据相关临床表现，哮喘组进一步分为控制组、部分控制组、未控制组；咳嗽变异性哮喘组分为分为控制组、未控制组。均进行个人史、家族史、鼻炎史、用药史等相关病史采集，及FeNO检测，应用单因素方差分析比较不同亚型的哮喘儿童间FeNO值的差异，及不同病情的哮喘患儿间FeNO值的差异。结果：(1)哮喘组中控制组、部分控制组、未控制组的FeNO值差异显著高于健康对照儿童（控制组20.03±17.95PPB，部分控制组28.05±23.40PPB，未控制组42.77±33.53PPB，P0.05）；哮喘组中合并持续性变应性鼻炎者的FeNO值为33.09±29.20PPB，较无鼻炎史者（22.19±18.63PPB）及间歇鼻炎者（24.00±22.63PPB）显著升高（P0.05）。(2)咳嗽变异性哮喘儿童的FeNO值较健康对照儿童明显增高（P0.05），并与用药相关；其中控制组和未控制组间差异显著。(3)咳嗽变性哮喘控制组的FeNO值较哮喘控制组显著降低。结论：FeNO可用于区分不同亚型的哮喘，及控制、部分控制、未控制等不同病情的转归。FeNO与用药、年龄、变应性鼻炎等因素相关，还可作为哮喘治疗效果的良好参考依据。第三部分：呼出气一氧化氮与哮喘儿童肺功能的相关性分析目的：哮喘是一种可引起气道阻塞的慢性气道炎症，而呼出气一氧化氮（FeNO）是气道炎症的重要指标之一。本研究旨在比较哮喘儿童FeNO与肺功能各项指标的相关性，从而明确FeNO对于气道阻塞的诊断价值。方法：将2013年6月份至2013年9月份来我院哮喘专科门诊就诊的哮喘患儿共计1011例，采用纳库仑呼气分析仪及耶格肺功能检测仪器检测FeNO及肺功能FEV1、FVC、PEF、PEF25、PEF50、PEF75、MMEF等指标，应用一元线性相关与回归分析法分析FeNO与各项肺功能指标相关性。结果：（1）1011例哮喘儿童FeNO值为（24.84±23.00）PPB，与肺功能各项指标FEV1、FVC、PEF、PEF25、PEF50、PEF75、MMEF皆存在线性相关性；（2）FeNO与儿童哮喘的大气道肺功能指标FEV1、FVC、PEF呈线性负相关；（3）FeNO与儿童哮喘的小气道肺功能PEF25、PEF50、PEF75、MMEF呈线性负相关。结论：FeNO与儿童哮喘的大气道、小气道肺功能皆成线性负相关，在一定程度上反映了气道阻塞程度。
[Abstract]:Part I: analysis of factors affecting exhaled nitric oxide
Objective: exhalation of nitric oxide (FeNO) can be used to detect airway inflammation in asthma. The purpose of this study is to explore the application value of FeNO in the diagnosis of childhood asthma and to analyze its influencing factors.
Methods: 1068 children with asthma and 210 healthy controls were collected from June to June 2013 in our hospital. The related medical history was collected, FeNO was detected by FeNO, and the difference of FeNO values between children with asthma and healthy controls was compared with the two independent sample t test analysis, and a linear correlation and regression correlation analysis was used. The correlation between the FeNO value and the influencing factors of asthma was analyzed.
Results: (1) the FeNO value of the asthmatic children was (24.74 + 22.72) PPB, the average FeNO value of the healthy control group was (11.88 + 8.25) PPB, the FeNo value of the asthmatic children was significantly higher than that of the healthy control children (P0.05). (2) the FeNO values of the children with asthma and health control were all positively correlated with age, weight, body height and body surface area, but the allergy history of eczema and other systems The history of disease allergy and family allergy is not related; the FeNO value of asthmatic children is associated with the history of allergic rhinitis, existing allergic rhinitis, and long-term control of medication. (3) the FeNO value of asthmatic children is not related to the use of hormone and montelukast sodium in one week, and other existing allergic diseases outside asthma.
Conclusion: the FeNO value of children with asthma is significantly higher than that in healthy control children, and has a correlation with age, height, weight and allergic rhinitis, which can be used as a reference for diagnosis of asthma.
The second part: correlation between exhaled nitric oxide and disease and asthma subtypes.
Objective: To investigate the correlation between exhaled nitric oxide (FeNO) and the subtypes of asthma in children.
Methods: from June 2012 to September 2013, 1068 cases of asthma were diagnosed in our hospital from 3 to 14 years old. According to the asthma subtype, the asthma group was divided into asthma group and cough variant asthma group. According to the related clinical manifestations, the asthma group was further divided into control group, partial control group and uncontrolled group, and the cough variant asthma group was divided into control group. The individual history, family history, the history of rhinitis, the history of rhinitis and the history of drug use were collected, and FeNO tests were carried out. The difference of FeNO values among children with different subtypes of asthma and the difference of FeNO between different asthma children were compared with the single factor analysis of variance.
Results: (1) the FeNO values of the control group in the asthma group and the control group were significantly higher than those in the control group (20.03 + 17.95PPB in control group, 28.05 + 23.40PPB in control group, 42.77 + 33.53PPB in uncontrolled group, P0.05), and 33.09 + 29.20PPB in the patients with persistent allergic rhinitis in the asthmatic group, and 22.1 (22.1). 9 + 18.63PPB) and intermittent rhinitis (24 + 22.63PPB) significantly increased (P0.05). (2) the FeNO value of children with cough variant asthma was significantly higher than that of the healthy control children (P0.05), and was related to the drug use, and the difference between the control group and the uncontrolled group was significant. (3) the FeNO value of the cough variant asthma control group was significantly lower than that of the asthma control group.
Conclusion: FeNO can be used to distinguish different subtypes of asthma, and control, control, uncontrolled and uncontrolled changes of.FeNO with drugs, age, allergic rhinitis and other factors, and can also be used as a good reference for the treatment of asthma.
The third part: correlation between exhaled nitric oxide and lung function in asthmatic children.
Objective: asthma is a chronic airway inflammation that can cause airway obstruction, and exhalation of nitric oxide (FeNO) is one of the important indicators of airway inflammation. The purpose of this study is to compare the correlation between FeNO and various indexes of lung function in asthmatic children, so as to determine the value of FeNO in the diagnosis of airway obstruction.
Methods: a total of 1011 asthmatic children from June 2013 to September 2013 were treated for asthma. FeNO and lung function FEV1, FVC, PEF, PEF25, PEF50, PEF75, MMEF and other indexes were detected by the nancoulomb breath analyzer and the instrument of the lung function test. The single linear correlation and regression analysis was used to analyze FeNO and various lung functions. Can be index correlation.
Results: (1) the FeNO value of 1011 asthmatic children was (24.84 + 23) PPB, and there were linear correlation with various indexes of lung function FEV1, FVC, PEF, PEF25, PEF50, PEF75, MMEF, and FeNO and FEV1, FVC and negative correlation with the lung function index of the large airway in children with asthma. (3) There is a negative correlation between sex.
Conclusion: FeNO is negatively correlated with airway function and small airway function in children with asthma, to a certain extent, reflects airway obstruction.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R725.6

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