Nandan Devki, Kansal Prachi, Patharia Neha, Goyal Parul
Department of Pediatrics, PGIMER, Dr. RML Hospital, New Delhi, India.
J Lab Physicians. 2016 Jul-Dec;8(2):90-5. doi: 10.4103/0974-2727.180788.
The objective of this study is to measure levels of nitrites in induced sputum in children with asthma and correlate it with clinical asthma parameters.
This prospective observational study was done in PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, on 91 children aged 7-18 years with mild and moderate persistent asthma. Patients were specifically evaluated for five clinical parameters of asthma (i.e. Days of acute exacerbations, use of salbutamol as rescue medication, emergency visits, nights with cough, days of school absence) and induced sputum nitrite levels was done at the time of enrollment and 3 months after treatment with inhaled budesonide.
The mean age of subjects was 10.79 ± 2.563yrs. Six (6.59%) patients were not able to perform induced sputum, eighty five (93.41%) patients were suitable for data analysis. There was significant reduction in sputum nitrite levels from 33.42 ± 22.04nmol/ml at enrollment to 11.72 ± 5.61 nmol/ml (P < 0.0005) after 3 months of inhaled budesonide therapy. Significant positive correlation was found between reduction in sputum nitrite level and control of asthma symptoms: Days of acute exacerbations(r value = 0.548, P value = 0.0001), Days of salbutamol use as rescue medication (r value = 0.431, P value =< 0.0001), Number of emergency visits(r value = 0.414, P value = 0.0001), Nights with cough (r value = 0.259, P value = 0.0169), Days of school absence(r value = 0.411, P value = 0.0001). Sputum nitrite levels were significantly higher in moderate persistent asthmatics as compared to mild at the time of enrollment (P < 0.0005), which shows that induced sputum nitrite levels correlate with asthma severity.
This study confirms that nitrites in induced sputum correlate well with clinical asthma parameters and asthma severity in children and is a simple, non invasive, and cheap method which can be used as a parameter for monitoring of asthma.
本研究的目的是测量哮喘患儿诱导痰中的亚硝酸盐水平，并将其与临床哮喘参数相关联。
这项前瞻性观察性研究在新德里的拉姆·马诺哈尔·洛希亚医院PGIMER对91名7至18岁的轻度和中度持续性哮喘儿童进行。对患者进行了哮喘的五个临床参数（即急性加重天数、使用沙丁胺醇作为急救药物、急诊就诊次数、咳嗽夜间数、缺课天数）的专门评估，并在入组时和吸入布地奈德治疗3个月后测定诱导痰亚硝酸盐水平。
受试者的平均年龄为10.79±2.563岁。6名（6.59%）患者无法进行诱导痰检查，85名（93.41%）患者适合进行数据分析。吸入布地奈德治疗3个月后，痰中亚硝酸盐水平从入组时的33.42±22.04nmol/ml显著降低至11.72±5.61nmol/ml（P<0.0005）。痰中亚硝酸盐水平的降低与哮喘症状的控制之间存在显著正相关：急性加重天数（r值=0.548，P值=0.0001）、使用沙丁胺醇作为急救药物的天数（r值=0.431，P值<0.0001）、急诊就诊次数（r值=0.414，P值=0.0001）、咳嗽夜间数（r值=0.259，P值=0.0169）、缺课天数（r值=0.411，P值=0.0001）。入组时，中度持续性哮喘患者的痰中亚硝酸盐水平显著高于轻度患者（P<0.0005），这表明诱导痰亚硝酸盐水平与哮喘严重程度相关。
本研究证实，诱导痰中的亚硝酸盐与儿童临床哮喘参数和哮喘严重程度密切相关，是一种简单、无创且廉价的方法，可作为监测哮喘的一个参数。
