Yin Sha-Sha, Liu Hong, Gao Xing
Int J Clin Pharmacol Ther. 2017 Jan;55(1):66-77. doi: 10.5414/CP202570.
Objective: Our study aims to explore the correlation between fractional exhaled nitric oxide (FeNO) and inhaled corticosteroids (ICS) efficacy in childhood bronchial asthma (BA).
247 pediatric BA patients were selected and divided into 3 treatment groups based on drug therapy: treatment group 1 (seretide, n = 86), treatment group 2 (budesonide, n = 79), and treatment group 3 (salbutamol, n = 82). Another 90 healthy children were recruited as control group. FeNO, FEV1%pred, FEV1/FVC, MEF25%, MEF50% and PEF%, total serum IgE, EOS%, induced sputum EOS% and supernatant inflammatory indexes (ECP, IL-8, and TNF-α) of sputum, ECP, IL-8 and TNF-α were detected.
Compared with pretreatment, 6 months posttreatment, FeNO, induced sputum EOS%, supernatant inflammatory indexes decreased (all p < 0.05), but pulmonary function indexes and childhood asthma control test (C-ACT) increased in treatment groups (all p < 0.05). FeNO, induced sputum EOS%, and supernatant inflammatory indexes in treatment group 1 were lower than those in treatment group 2 and 3 (all p < 0.05); total serum IgE and peripheral blood EOS% in treatment group 1 and 2 were lower but pulmonary function indexes were higher than those in treatment group 3 (all p < 0.05); according to Pearson correlation analysis, in both ICS and non-ICS groups, FeNO was positively correlated to ECP but negatively to C-ACT.
ICS is effective in BA treatment, and FeNO associated with ICS efficacy is an indicator for BA intervention. FeNO combing with pulmonary function indexes had a predictive value in BA response.
目的:本研究旨在探讨儿童支气管哮喘(BA)中呼出气一氧化氮分数(FeNO)与吸入性糖皮质激素(ICS)疗效之间的相关性。
选取247例儿科BA患者,根据药物治疗分为3个治疗组:治疗组1(舒利迭,n = 86)、治疗组2(布地奈德,n = 79)和治疗组3(沙丁胺醇,n = 82)。另招募90名健康儿童作为对照组。检测FeNO、FEV1%预计值、FEV1/FVC、MEF25%、MEF50%和PEF%、总血清IgE、EOS%、诱导痰EOS%以及痰液上清液炎症指标(ECP、IL-8和TNF-α)、ECP、IL-8和TNF-α。
与治疗前相比,治疗6个月后,治疗组的FeNO、诱导痰EOS%、上清液炎症指标降低(均p < 0.05),但肺功能指标和儿童哮喘控制测试(C-ACT)升高(均p < 0.05)。治疗组1的FeNO、诱导痰EOS%和上清液炎症指标低于治疗组2和3(均p < 0.05);治疗组1和2的总血清IgE和外周血EOS%较低,但肺功能指标高于治疗组3(均p < 0.05);根据Pearson相关性分析,在ICS组和非ICS组中,FeNO与ECP呈正相关,但与C-ACT呈负相关。
ICS对BA治疗有效,与ICS疗效相关的FeNO是BA干预的一个指标。FeNO与肺功能指标相结合对BA反应具有预测价值。