Evjenth Bjørg, Hansen Tonje E, Holt Jan
a Department of Pediatrics, Division of Pediatrics , Obstetrics and Women's Health, Nordland Hospital , Bodø , Norway and.
J Asthma. 2015 Oct;52(8):795-800. doi: 10.3109/02770903.2015.1014099. Epub 2015 May 19.
Fractional exhaled nitric oxide (FENO) and exercise testing are widely used for the evaluation of pediatric asthma. The evidence relating to the effects of strenuous exercise on FENO in children is conflicting. Little information is available on the association between exercise and FENO in relation to allergic rhinoconjunctivitis (AR). We aimed to investigate the effects of AR on children's FENO in response to a standardized treadmill exercise test.
A total of 124 children with current asthma and 124 non-asthmatic children aged 8-16 years were studied. FENO was measured at baseline, at 1 and 30 min after an exercise challenge test using the single breath technique with EcoMedics Exhalyzer. A structured parental interview, spirometry, serum allergen-specific IgE and skin prick tests were performed.
Baseline FENO was higher in both asthmatics and non-asthmatics with AR than without AR (both p < 0.001). The FENO time trend was dependent on AR (p = 0.039), irrespective of asthma (p = 0.876). In children with AR, FENO had declined at 1 min by a mean of 6.1 ppb with a 95% confidence level of 5.1-7.5 ppb; at 30 min, the reduction was 2.8 (2.5-3.3) ppb. In children without AR, at 1 min the decline in FENO was 2.7 (2.1-3.5) ppb and by 30 min post-exercise it was 1.6 (1.3-2.0) ppb.
The impact of exercise on FENO was dependent on the allergic phenotype, regardless of asthma status. FENO decreased immediately after exercise, and did not return to baseline level within 30 min.
呼出一氧化氮分数（FENO）和运动试验广泛用于儿童哮喘的评估。关于剧烈运动对儿童FENO影响的证据相互矛盾。关于运动与变应性鼻结膜炎（AR）相关的FENO之间的关联，现有信息很少。我们旨在研究AR对儿童在标准化跑步机运动试验中的FENO的影响。
共研究了124名8至16岁的现患哮喘儿童和124名非哮喘儿童。使用EcoMedics呼出分析仪通过单次呼吸技术在运动激发试验后1分钟和30分钟时测量基线FENO。进行了结构化的家长访谈、肺功能测定、血清过敏原特异性IgE和皮肤点刺试验。
患有AR的哮喘儿童和非哮喘儿童的基线FENO均高于无AR者（均p < 0.001）。FENO的时间趋势取决于AR（p = 0.039），与哮喘无关（p = 0.876）。在患有AR的儿童中，FENO在1分钟时平均下降了6.1 ppb，95%置信区间为5.1 - 7.5 ppb；在30分钟时，下降了2.8（2.5 - 3.3）ppb。在无AR的儿童中，FENO在1分钟时下降了2.7（2.1 - 3.5）ppb，运动后30分钟时下降了1.6（1.3 - 2.0）ppb。
运动对FENO的影响取决于过敏表型，与哮喘状态无关。运动后FENO立即下降，且在30分钟内未恢复到基线水平。
