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山东大学学报 (医学版) ›› 2025, Vol. 63 ›› Issue (6): 38-44.doi: 10.6040/j.issn.1671-7554.0.2025.0347

• 临床医学 • 上一篇    

哮喘发作期FeNO升高儿童肺功能舒张试验的特点分析

曹洛菲1,2,王珊珊3,王金荣2,姜荷云4,苗瑜2,马光增2   

  1. 1.山东中医药大学第二临床医学院, 山东 济南 250004;2.山东第一医科大学附属省立医院小儿呼吸科, 山东 济南 250021;3.山东第一医科大学附属省立医院公共卫生科, 山东 济南 250021;4.山东第一医科大学附属济南妇幼保健院, 山东 济南 250001
  • 发布日期:2025-07-08
  • 通讯作者: 王金荣. E-mail:Jrwang60@163.com
  • 基金资助:
    山东省自然科学基金(ZR2022MH254)

Analysis of the characteristics of bronchial dilation test in children with FeNO elevation during asthma exacerbation

CAO Luofei1,2, WANG Shanshan3, WANG Jinrong2, JIANG Heyun4, MIAO Yu2, MA Guangzeng2   

  1. 1. Second Clinical Medical College of Shandong University of Traditional Chinese Medicine, Jinan 250004, Shandong, China;
    2. Department of Pediatric Respiratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China;
    3. Department of Public Health, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China;
    4. Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan 250001, Shandong, China
  • Published:2025-07-08

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摘要： 目的 分析不同呼出气一氧化氮(fractional concentration of exhaled nitric oxide, FeNO)水平哮喘发作期儿童肺功能指标支气管舒张试验(bronchial dilation test, BDT)后变化特点。 方法 选取2022年1月至2023年12月就诊于山东第一医科大学附属省立医院小儿呼吸科门诊5~12岁哮喘发作期儿童为研究对象,按患儿FeNO结果分为FeNO正常组与FeNO升高组。比较两组儿童各项肺功能参数及BDT后肺功能参数改善率,并分析FeNO与肺功能参数及其舒张后改善率的相关性。 结果 共纳入哮喘发作期儿童268例,其中211例(78.74%)FeNO升高。两组哮喘儿童肺功能主要参数第1秒用力呼气容积(forced expiratory volume in one second, FEV1)、第1秒用力呼气容积占用力肺活量比值(forced expiratory volume in one second to forced vital capacity ratio, FEV1/FVC)、最大呼气流量(peak expiratory flow, PEF)、用力呼气50%肺活量的瞬间流量(forced expiratory flow at 50% vital capacity, FEF50)、用力呼气75%肺活量的瞬间流量(forced expiratory flow at 75% vital capacity, FEF75)、最大呼气中期流量(maximum midexpiratory flow, MMEF)中位水平差异无统计学意义(P>0.05)。BDT后,FeNO升高组FEV1、FEF50、MMEF改善率中位水平均显著高于FeNO正常组(P<0.05);FeNO升高组儿童FEF50、FEF75、MMEF改善率阳性人数占比显著多于FeNO正常组儿童(P<0.05)。FeNO与FEV1、FEV1/FVC弱负相关(P<0.05);FeNO与BDT后FEV1、PEF、FEF50和MMEF改善率正相关(P<0.05)。 结论 多数哮喘发作期儿童FeNO水平升高,表明儿童哮喘发作以Ⅱ型炎症为主。FeNO升高的急性发作期哮喘儿童BDT后改善显著增加,尤其以小气道功能改善为主要特点。此外,FeNO与FEV1、FEF50和MMEF舒张后改善率正相关。

关键词: 儿童, 支气管哮喘, 呼出气一氧化氮, 肺通气功能, 支气管舒张试验

Abstract: Objective To analyze the improvement of pulmonary function indices after the bronchial dilation test(BDT)in children with asthma at different levels of fractional concentration of exhaled nitric oxide(FeNO). Methods This study included children with asthma exacerbation aged 5-12 who visited the Pediatric Respiratory Clinic of Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2022 to December 2023. They were divided into the normal FeNO group and the high FeNO group based on their fractional concentration of FeNO results. Then the pulmonary function indices between the two groups of children were compared, as well as the improvement rate of pulmonary function indices after BDT, and the correlation between FeNO and pulmonary function indices and their improvement rate was analyzed. Results A total of 268 children with asthma exacerbations were included, of whom 211(78.74%)had elevated FeNO. The median values of forced expiratory volume in one second(FEV1), forced expiratory volume in one second to forced vital capacity ratio(FEV1/FVC), peak expiratory flow(PEF), forced expiratory flow at 50% vital capacity(FEF50), forced expiratory flow at 75% vital capacity(FEF75)and maximum midexpiratory flow(MMEF)were not significantly different between the two groups(P>0.05). The median improvement rates of FEV1, FEF50 and MMEF in the high FeNO group were higher than those in the normal FeNO group(P<0.05). The proportion of children with positive FEF50, FEF75, and MMEF improvement rates in the high FeNO group was significantly higher than that in the normal FeNO group(P<0.05). FeNO was weakly negatively correlated with FEV1, FEV1/FVC(P<0.05); FeNO was positively correlated with FEV1, PEF, FEF50 and MMEF improvement rate after BDT(P< 0.05). Conclusion Most children with asthma during the exacerbation period have elevated levels of FeNO, indicating that type II inflammation is the main cause of childhood asthma exacerbation. The improvement of BDT in children with exacerbation of asthma with elevated FeNO is significantly increased, especially characterized by the improvement of small airway function. FeNO is positively correlated with bronchial dilation test improvement rates in FEV1, FEF50, and MMEF.

Key words: Children, Bronchial asthma, Exhaled nitric oxide, Spirometry, Bronchial dilation test

中图分类号: 

  • R725.6
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