Qin Jiangjiao, Liu Fangjun, Wang Ting, Fu Zhou, Lin Ying, Wang Xia, Zhao Jing, Liu Sha
Department of Pulmonary Function, Children's Hospital of Chongqing Medical University, Chongqing, China.
National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China.
Front Pediatr. 2025 Jul 25;13:1388951. doi: 10.3389/fped.2025.1388951. eCollection 2025.
To investigate the correlation between tidal breathing pulmonary function parameters combined with mixed exhaled gas nitric oxide values and the degree of airway hyperresponsiveness (AHR) in children aged 0-3 years with suspected asthma.
In this retrospective study, we collected baseline clinical data, tidal breathing pulmonary function parameters (measured before methacholine inhalation), fractional exhaled nitric oxide (FeNO) levels, and methacholine challenge test (MCT) results from 818 pediatric asthma patients treated at the Children's Hospital of Chongqing Medical University between January 2021 and June 2023. Baseline data, tidal respiratory pulmonary function parameters, and FeNO values were used to analyze their correlation with AHR. Ordinal multiclass logistic regression analysis was used to identify factors influencing AHR. The receiver operating characteristic (ROC) curve was performed to evaluate the efficacy of predicting AHR using tidal breathing pulmonary function parameters and FeNO values.
Intergroup comparisons showed significant differences in age, weight, height, FeNO, TPTEF/TE, RR, TI/TE, TEF50/TIF50, and PTFE/TEF25 ( < 0.05). Further ordinal multiclass logistic regression analysis revealed that increases in FeNO, RR, and PTEF/TEF25 were significantly positively correlated with AHR severity ( < 0.001), while age was significantly negatively correlated ( < 0.001). FeNO showed reasonable accuracy in predicting AHR at methacholine concentrations of 8 mg/ml (AUC=0.774) and a cut-off value of 14 ppb (sensitivity 88.5%, specificity 63.8%). The combined parameters (FeNO, RR, PTFE/TEF25, and age) showed high accuracy in predicting AHR at methacholine concentrations of 0.5 mg/ml (AUC=0.847).
Our study revealed that Current airway inflammation and airway obstruction predicted AHR at this point.FeNO, RR, PTEF/TEF25, and age were effective predictive parameters for the degree of AHR in children aged 0-3 years with suspected asthma; FeNO >14 ppb served as an independent factor suggesting AHR in children at methacholine concentrations of 8 mg/ml, and the combined parameters showed better predictive efficacy.
探讨潮气呼吸肺功能参数联合混合呼出气一氧化氮值与0-3岁疑似哮喘儿童气道高反应性（AHR）程度之间的相关性。
在这项回顾性研究中，我们收集了2021年1月至2023年6月期间在重庆医科大学附属儿童医院接受治疗的818例小儿哮喘患者的基线临床资料、潮气呼吸肺功能参数（在吸入乙酰甲胆碱前测量）、呼出气一氧化氮分数（FeNO）水平以及乙酰甲胆碱激发试验（MCT）结果。使用基线数据、潮气呼吸肺功能参数和FeNO值来分析它们与AHR的相关性。采用有序多分类逻辑回归分析来确定影响AHR的因素。绘制受试者工作特征（ROC）曲线以评估使用潮气呼吸肺功能参数和FeNO值预测AHR的效能。
组间比较显示年龄、体重、身高、FeNO、TPTEF/TE、RR、TI/TE、TEF50/TIF50和PTFE/TEF25存在显著差异（P<0.05）。进一步的有序多分类逻辑回归分析显示，FeNO、RR和PTEF/TEF25的升高与AHR严重程度显著正相关（P<0.001），而年龄与AHR严重程度显著负相关（P<0.001）。在乙酰甲胆碱浓度为8mg/ml时，FeNO对AHR的预测具有合理的准确性（AUC=0.774），截断值为14ppb（灵敏度88.5%，特异性63.8%）。联合参数（FeNO、RR、PTFE/TEF25和年龄）在乙酰甲胆碱浓度为0.5mg/ml时对AHR的预测具有较高的准确性（AUC=0.847）。
我们的研究表明，当前的气道炎症和气道阻塞可预测此时的AHR。FeNO、RR、PTEF/TEF25和年龄是0-3岁疑似哮喘儿童AHR程度的有效预测参数；在乙酰甲胆碱浓度为8mg/ml时，FeNO>14ppb是提示儿童AHR的独立因素，联合参数显示出更好的预测效能。
