Malmberg L P, Petäys T, Haahtela T, Laatikainen T, Jousilahti P, Vartiainen E, Mäkelä M J
Department of Allergy, Helsinki University Central Hospital, Helsinki, Finland.
Pediatr Pulmonol. 2006 Jul;41(7):635-42. doi: 10.1002/ppul.20417.
Exhaled nitric oxide (FENO) was proposed as a marker of airway inflammation, but data about FENO in healthy children measured with standardized methods are so far limited. In order to assess the determinants of FENO in healthy children, we investigated a population-based sample of school-age children (n = 276) with a questionnaire, skin-prick tests, spirometry, and the measurement of FENO. The FENO of 114 nonatopic and nonsmoking children considered healthy were analyzed with stepwise multiple regression analysis, which showed significant associations with age, standing height, weight, and body surface area, but not with gender. Height was found to be the best independent variable for the regression equation for FENO, which on average showed an increase in the height range of 120-180 cm from 7 to 14 ppb. In the random sample of children, increased FENO was associated with atopy (odds ratio, 9.0; 95% confidence interval, 3.9-21.1; P < 0.0001), and significantly with allergic rhinitis and atopic dermatitis, but not with asthma. Respiratory symptom-free children with skin-prick test positivity had significantly higher FENO than healthy nonatopic subjects. We conclude that height is the best determinant of FENO in healthy children. Due to the strong effect of atopy, FENO data should not be interpreted without knowing the atopic status of the child. The present reference values of FENO may serve in clinical assessments for measuring airway inflammation in children.
呼出一氧化氮（FENO）被提议作为气道炎症的标志物，但迄今为止，关于用标准化方法测量的健康儿童FENO的数据有限。为了评估健康儿童FENO的决定因素，我们通过问卷调查、皮肤点刺试验、肺功能测定和FENO测量，对一个基于人群的学龄儿童样本（n = 276）进行了调查。对114名被认为健康的非特应性且不吸烟儿童的FENO进行逐步多元回归分析，结果显示其与年龄、身高、体重和体表面积显著相关，但与性别无关。发现身高是FENO回归方程的最佳自变量，在身高范围为120 - 180 cm时，FENO平均从7 ppb增加到14 ppb。在儿童随机样本中，FENO升高与特应性相关（优势比，9.0；95%置信区间，3.9 - 21.1；P < 0.0001），且与过敏性鼻炎和特应性皮炎显著相关，但与哮喘无关。皮肤点刺试验阳性的无呼吸道症状儿童的FENO显著高于健康的非特应性受试者。我们得出结论，身高是健康儿童FENO的最佳决定因素。由于特应性的强烈影响，在不知道儿童特应性状态的情况下，不应解读FENO数据。目前的FENO参考值可用于临床评估儿童气道炎症。
