本文關(guān)鍵詞： 呼出氣一氧化氮(FeNO) 毛細(xì)支氣管炎 支氣管哮喘　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過(guò)檢測(cè)毛細(xì)支氣管炎患兒過(guò)敏原特異性免疫球蛋白E(Specific immunoglobulin E,s Ig E)、血清總Ig E、外周血嗜酸性粒細(xì)胞(Eosinophils,EOS)計(jì)數(shù)、呼出氣一氧化氮(Fraction exhaled nitric oxide,Fe NO)及日后反復(fù)喘息和哮喘的發(fā)生率,探討Fe NO測(cè)定在毛細(xì)支氣管炎患兒遠(yuǎn)期轉(zhuǎn)歸中的臨床意義。方法:將符合毛細(xì)支氣管炎入選標(biāo)準(zhǔn)的患兒,根據(jù)有無(wú)特應(yīng)性體質(zhì)分為特應(yīng)性體質(zhì)組和非特應(yīng)性體質(zhì)組。分別檢測(cè)并記錄兩組患兒在急性期、治療后1個(gè)月、3個(gè)月Fe NO、外周血EOS、血清總Ig E及隨訪6個(gè)月、12個(gè)月反復(fù)喘息和哮喘的發(fā)生率。結(jié)果:(1)無(wú)論是急性期、治療后1個(gè)月及3個(gè)月的Fe NO、血清總Ig E及EOS特應(yīng)性體質(zhì)組均較非特應(yīng)性體質(zhì)組高,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)特應(yīng)性體質(zhì)組Fe NO、Ig E及EOS在治療后1個(gè)月及3個(gè)月后與急性期相比,逐漸下降,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(3)非特應(yīng)性體質(zhì)組患兒的Fe NO、Ig E及EOS在治療1月及3個(gè)月后與急性期相比,逐漸下降,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(4)在6個(gè)月、12個(gè)月的隨訪中,特應(yīng)性體質(zhì)組患兒在喘息次數(shù)及哮喘發(fā)生率均高于非特應(yīng)性體質(zhì)組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(5)特應(yīng)性體質(zhì)組急性期Fe NO與6個(gè)月及12個(gè)月隨訪喘息次數(shù)成顯著正相關(guān)(P0.01)。結(jié)論:(1)特應(yīng)性體質(zhì)組的毛細(xì)支氣管炎患兒急性期、治療后1個(gè)月及3個(gè)月的Fe NO、血清總Ig E及EOS均較非特應(yīng)性體質(zhì)組高,并且特應(yīng)性體質(zhì)組后期反復(fù)喘息的次數(shù)和發(fā)展為哮喘的可能性高于非特應(yīng)性體質(zhì)組,以上提示特應(yīng)性體質(zhì)是毛細(xì)支氣管炎患兒日后反復(fù)喘息及發(fā)展為哮喘的高危因素。(2)Fe NO并不是在所有的毛細(xì)支氣管炎患兒中都升高,特應(yīng)性體質(zhì)的毛細(xì)支氣管炎患兒Fe NO與后期隨訪反復(fù)喘息次數(shù)成正相關(guān),提示Fe NO可能成為預(yù)測(cè)毛細(xì)支氣管炎患兒日后反復(fù)喘息和發(fā)展為哮喘的指標(biāo)。
[Abstract]:Objective: to detect the count of allergen specific immunoglobulin (Ig E), serum total IgE, peripheral blood eosinophilic eosinophilus (EOS), exhale nitric oxide (no) fraction exhaled nitric oxide-iron (no), and the incidence of recurrent wheezing and asthma in children with bronchiolitis. To explore the clinical significance of determination of Fe no in the long term outcome of bronchiolitis in children. They were divided into atopic constitution group and non-atopic constitution group according to whether they had atopic constitution. One month, three months after treatment, FeNO, peripheral blood EOS, serum total IgE and the incidence of recurrent wheezing and asthma were observed for 6 months and 12 months after treatment. The serum levels of total IgE and EOS atopic constitution were significantly higher in 1 month and 3 months after treatment than those in non-atopic group, and the difference was statistically significant (P 0.05. 0. 0. 0. 2) FeNOIg E and EOS in the atopic constitution group were significantly higher than those in the acute phase 1 and 3 months after treatment. The levels of FeNOIg E and EOS in non-atopic physique group decreased gradually compared with those in acute stage in January and 3 months after treatment, and the difference was statistically significant (P 0.05) in 6 months and 12 months after treatment. The frequency of wheezing and the incidence of asthma in atopic constitution group were higher than those in non-atopic constitution group. There was a significant positive correlation between FeNO in the acute phase of atopic physique and the wheezing times in 6 months and 12 months follow-up. Conclusion the children in the atopic constitution group had acute bronchiolitis in the acute stage. At 1 month and 3 months after treatment, the levels of serum IgE and EOS were higher in the atopic group than in the non-atopic constitution group, and the frequency of repeated wheezing and the possibility of asthma development in the anaphase of the atopic constitution group were higher than those in the non-atopic constitution group. These results suggest that atopic constitution is a high risk factor for recurrent wheezing and asthma development in children with bronchiolitis, and that no does not increase in all children with bronchiolitis. FeNO in children with atopic bronchiolitis was positively correlated with the repeated wheezing times in the follow-up period, suggesting that FeNO might be a predictor of recurrent wheezing and asthma in children with bronchiolitis.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R725.6

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