Cibella Fabio, Cuttitta Giuseppina, La Grutta Stefania, Passalacqua Giovanni, Viegi Giovanni
Consiglio Nazionale delle Ricerche, Istituto di Biomedicina e Immunologia Molecolare, Palermo, Italy.
Ann Allergy Asthma Immunol. 2008 Oct;101(4):407-12. doi: 10.1016/S1081-1206(10)60318-3.
Conflicting results exist about the meaning of exhaled nitric oxide (eNO) in epidemiologic studies, mainly because of the numerous factors that may affect the measurement.
To evaluate the role of the factors that influence eNO levels in a sample of schoolchildren with or without respiratory diseases. We studied 335 schoolchildren, ages 10 to 16 years, from 8 schools in Palermo, Italy. After a respiratory questionnaire was completed, spirometry, skin tests, and eNO measurements were performed.
Among 335 children, 13.7% reported symptoms of bronchial asthma, 46.9% reported symptoms of rhinitis, and 39.4% were asymptomatic. The ratio of forced expiratory volume in 1 second to forced vital capacity was 87.6% (SD, 6.4%) in the bronchial asthma group, 90.6% (SD, 5.0%) in the rhinitis group, and 90.4% (SD, 5.1%) in the asymptomatic group (P < .002). Atopic children constituted 52.2% of the bronchial asthma group, 40.1% of the rhinitis group, and 28.8% of the asymptomatic group. Among atopic children, 102 (82%) had a positive skin test result for Dermatophagoides. Median eNO was 12.6 ppb in nonatopic children and 21.2 ppb in atopic children (P < .001, by Mann-Whitney U test). Among asymptomatic children, atopic children had significantly higher eNO levels than did nonatopic children (P < .001). In nonatopic children, no difference was found in log transformation eNO among healthy, rhinitic, or asthmatic children. Log transformation eNO increased with the number of positive skin test results (P < .001). Atopy, asthma, male sex, and indoor allergens were predictors of increased eNO in a logistic model.
Atopy (in particular, sensitization to indoor and perennial allergens) is strongly associated with higher eNO levels. Such association is enhanced by asthma.
在流行病学研究中，关于呼出一氧化氮（eNO）的意义存在相互矛盾的结果，主要是因为有许多因素可能影响测量结果。
评估影响有或无呼吸道疾病的学童样本中eNO水平的因素的作用。我们研究了来自意大利巴勒莫8所学校的335名10至16岁的学童。完成呼吸问卷后，进行了肺活量测定、皮肤试验和eNO测量。
在335名儿童中，13.7%报告有支气管哮喘症状，46.9%报告有鼻炎症状，39.4%无症状。支气管哮喘组1秒用力呼气容积与用力肺活量的比值为87.6%（标准差，6.4%），鼻炎组为90.6%（标准差，5.0%），无症状组为90.4%（标准差，5.1%）（P <.002）。特应性儿童在支气管哮喘组中占52.2%，在鼻炎组中占40.1%，在无症状组中占28.8%。在特应性儿童中，102名（82%）对尘螨的皮肤试验结果呈阳性。非特应性儿童的eNO中位数为12.6 ppb，特应性儿童为21.2 ppb（通过曼-惠特尼U检验，P <.001）。在无症状儿童中，特应性儿童的eNO水平显著高于非特应性儿童（P <.001）。在非特应性儿童中，健康、鼻炎或哮喘儿童的eNO对数转换值无差异。eNO对数转换值随皮肤试验阳性结果数量的增加而增加（P <.001）。在逻辑模型中，特应性、哮喘、男性性别和室内过敏原是eNO升高的预测因素。
特应性（特别是对室内和常年性过敏原的致敏）与较高的eNO水平密切相关。哮喘会增强这种关联。
