Department of Pediatrics, First Affiliated Hospital to Army Medical University, NO.30, Gao Tanyan Street, Shapingba District, Chongqing, China.
Respir Med. 2018 Dec;145:8-13. doi: 10.1016/j.rmed.2018.10.009. Epub 2018 Oct 16.
This study investigated the accuracy of impulse oscillometry (IOS) combined with fractional exhaled nitric oxide (FeNO) to assess asthma control among preschool children.
A total of 79 preschool children(3-6 year old) with asthma and 25 healthy preschool children who visited a paediatrician were enrolled in this study. All of the children were tested for allergens, respiratory system resistance (at 5 and 20 Hz [R5, R20]), respiratory system reactance (at 5 Hz [X5]), the resonant frequency of reactance (Fres), and the area under the reactance curve (between 5 Hz and Fres (reactance area [AX]) using IOS and FeNO. A paediatric respiratory specialist who was unaware of the IOS and FeNO results assigned children with asthma to either the asthma-controlled group (n = 27) or the asthma-uncontrolled group (n = 52) based on the Global Initiative for Asthma (GINA) criteria. A healthy control group (n = 25) was also included. The relationships between the FeNO and IOS values as well as the asthma control of the three groups were analysed, and the areas under the curve (AUCs) were calculated for each measure.
(1) During the controlled group, means±standard deviations of AX, R5-20, R5, X5 and FeNO were 26.15 ± 7.534, 3.52 ± 1.311,9.97 ± 1.576,-3.85 ± 0.572,-3.85 ± 0.572. During the uncontrolled group, means±standard deviations of AX,R5-20,R5,X5 and FeNO were 38.34 ± 13.563,5.36 ± 1.545,11.41 ± 2.029,-5.07 ± 1.554,36.40 ± 21.07. Among preschool children, significant differences were observed between the controlled and uncontrolled group with regard to the small airway functional parameters (AX, R5-20, R5, and X5) and FeNO(P <0.05).(2) A receiver operating characteristic (ROC) analysis showed that the AUCs were 0.786 for FeNO alone, 0.751 for X5 alone, and 0.866 for X5 combined with FeNO (cut-off value: 27 ppb).
FeNO combined with the small airway function parameter X5 accurately assessed asthma control among preschool children.
本研究旨在探讨脉冲震荡（IOS）联合呼出气一氧化氮（FeNO）测定评估学龄前儿童哮喘控制情况的准确性。
本研究共纳入 79 例哮喘学龄前儿童（3-6 岁）和 25 例健康学龄前儿童，所有儿童均接受过敏原检测、5Hz 和 20Hz 呼吸阻力（R5、R20）、5Hz 呼吸电抗（X5）、电抗谐振频率（Fres）和电抗曲线下面积（5Hz 与 Fres 之间的电抗面积[AX]）的 IOS 和 FeNO 检测。一位不了解 IOS 和 FeNO 结果的儿科呼吸专家根据全球哮喘倡议（GINA）标准将哮喘儿童分为哮喘控制组（n=27）和哮喘未控制组（n=52），同时纳入健康对照组（n=25）。分析三组之间 FeNO 和 IOS 值与哮喘控制的关系，并计算各指标的曲线下面积（AUC）。
（1）在控制组中，AX、R5-20、R5、X5 和 FeNO 的平均值±标准差分别为 26.15±7.534、3.52±1.311、9.97±1.576、-3.85±0.572、-3.85±0.572。在未控制组中，AX、R5-20、R5、X5 和 FeNO 的平均值±标准差分别为 38.34±13.563、5.36±1.545、11.41±2.029、-5.07±1.554、36.40±21.07。在学龄前儿童中，控制组和未控制组之间的小气道功能参数（AX、R5-20、R5 和 X5）和 FeNO 差异有统计学意义（P<0.05）。（2）ROC 分析显示，FeNO 单独的 AUC 为 0.786，X5 单独的 AUC 为 0.751，X5 联合 FeNO 的 AUC 为 0.866（截断值：27ppb）。
FeNO 联合小气道功能参数 X5 可准确评估学龄前儿童哮喘控制情况。
