Kovesi Tom, Dales Robert
Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada.
Pediatr Pulmonol. 2008 Dec;43(12):1198-205. doi: 10.1002/ppul.20927.
To test the association between reported allergy and allergic diseases, respiratory symptoms, and the fractional concentration of exhaled nitric oxide (FeNO), in a community sample of school aged children.
We administered a respiratory questionnaire and measured FeNO in a cross-sectional study of 1,135 children.
FeNO was significantly greater in children with reported asthma (20.3 (standard deviation (SD) 21.3) parts per billion (ppb)) or allergies (18.1 (SD 18.0) ppb) than in healthy children (14.0 (SD 13.4) ppb). It was greater in children with asthma and reported allergies (22.8 (SD 23.6) ppb), than in children with asthma but no allergies (15.8 (SD 15.6) ppb) (overall P-value between disease groups = 0.002). FeNO was not related to respiratory symptoms in healthy children. Eczema was associated with an elevated FeNO concentration, even in the absence of respiratory symptoms. Some children with reported allergies but not asthma who had respiratory symptoms suggestive of asthma had elevated FeNO concentrations, and the proportion of healthy children with reported bronchitis or pneumonia in the past year who had an abnormally high FeNO concentration was significantly elevated.
In a community sample of children, FeNO concentrations appear to reflect allergic conditions, including allergic asthma, reported allergies, and eczema, rather than just asthma, particularly since asthma in children may be non-allergic. FeNO is similarly elevated in school aged children with reported asthma or reported allergies. FeNO is higher in children with asthma and allergies than in children with asthma alone. However, an elevated FeNO may help alert the clinician to the possibility of undiagnosed asthma.
在一个学龄儿童社区样本中，检测报告的过敏与过敏性疾病、呼吸道症状以及呼出一氧化氮分数浓度（FeNO）之间的关联。
在一项对1135名儿童的横断面研究中，我们发放了一份呼吸问卷并测量了FeNO。
报告患有哮喘（20.3（标准差（SD）21.3）十亿分之一（ppb））或过敏（18.1（SD 18.0）ppb）的儿童的FeNO显著高于健康儿童（14.0（SD 13.4）ppb）。患有哮喘且报告有过敏的儿童（22.8（SD 23.6）ppb）的FeNO高于患有哮喘但无过敏的儿童（15.8（SD 15.6）ppb）（疾病组之间的总体P值 = 0.002）。FeNO与健康儿童的呼吸道症状无关。即使没有呼吸道症状，湿疹也与FeNO浓度升高有关。一些报告有过敏但无哮喘且有提示哮喘的呼吸道症状的儿童FeNO浓度升高，并且在过去一年中报告有支气管炎或肺炎的健康儿童中，FeNO浓度异常高的比例显著升高。
在儿童社区样本中，FeNO浓度似乎反映了过敏状况，包括过敏性哮喘、报告的过敏和湿疹，而不仅仅是哮喘，特别是因为儿童哮喘可能是非过敏性的。报告患有哮喘或报告有过敏的学龄儿童的FeNO同样升高。患有哮喘和过敏的儿童的FeNO高于仅患有哮喘的儿童。然而，FeNO升高可能有助于提醒临床医生注意未确诊哮喘的可能性。
