呼出一氧化氮在预测儿童支气管高反应性中的价值。

The value of exhaled nitric oxide in predicting bronchial hyperresponsiveness in children.

作者信息

Ramser Michel, Hammer Juerg, Amacher Arnold, Trachsel Daniel

机构信息

Division of Pediatric Intensive Care and Pulmonology, University Children's Hospital of Basel, Basel, Switzerland.

出版信息

J Asthma. 2008 Apr;45(3):191-5. doi: 10.1080/02770900801890273.

DOI:10.1080/02770900801890273

PMID:18415824

Abstract

Reduced attention span and motor skills in children limit the practicability of bronchial provocation tests. To assess exhaled nitric oxide (FeNO) as a surrogate for bronchial hyperresponsiveness (BHR) in children with possible reactive airway disease, FeNO was measured using the single-breath method in 169 successive outpatients 11 +/- 5 years of age before lung function testing and subsequent bronchial provocation by exercise (n = 165) and methacholine (n = 134). Baseline forced expiratory volume in 1 second (FEV(1)) less than 80% of predicted and/or BHR were seen in 59%. FeNO correlated weakly with PD(20) to methacholine (r = -0.24, p < 0.05), but not with the change in FEV(1) due to exercise-induced bronchoconstriction (EIB) (r = 0.1, p > 0.05). The negative predictive value of FeNO less than 10 ppb for EIB was 94%, but overall accuracy for predicting BHR was low. Measurement of FeNO is not a substitute for bronchial provocation in children.

摘要

儿童注意力持续时间和运动技能的下降限制了支气管激发试验的实用性。为了评估呼出一氧化氮（FeNO）作为可能患有反应性气道疾病儿童支气管高反应性（BHR）的替代指标，在169名11±5岁的连续门诊患者进行肺功能测试及随后的运动激发试验（n = 165）和乙酰甲胆碱激发试验（n = 134）之前，采用单呼吸法测量了FeNO。59%的患者基线第1秒用力呼气量（FEV(1)）低于预测值的80%和/或存在BHR。FeNO与乙酰甲胆碱的PD(20)呈弱相关（r = -0.24，p < 0.05），但与运动诱发支气管收缩（EIB）导致的FEV(1)变化无关（r = 0.1，p > 0.05）。FeNO低于10 ppb对EIB的阴性预测值为94%，但预测BHR的总体准确性较低。在儿童中，测量FeNO不能替代支气管激发试验。