本文選題：上氣道咳嗽綜合征　切入點：呼出氣一氧化氮　出處：《大連醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:了解上氣道咳嗽綜合征的臨床特點,探究上氣道咳嗽綜合征體內(nèi)血清炎癥介質(zhì)水平與氣道炎癥水平的關(guān)系,以期探究替代輻射性及創(chuàng)傷性檢查的可能,為上氣道咳嗽綜合征的臨床診斷及治療提供臨床依據(jù)。方法:采用回顧性分析的研究方法,選擇2014年9月—2017年2月大連市兒童醫(yī)院慢性咳嗽門診就診,除外近期呼吸道感染者、其他病因引起的慢性咳嗽者、先天呼吸道畸形、及免疫功能障礙者,對符合兒童上氣道咳嗽綜合癥診斷標(biāo)準(zhǔn)的患兒進(jìn)行臨床癥狀、鼻竇CT結(jié)果、氣道呼出氣一氧化氮水平、血清白三烯水平分析總結(jié),并對其氣道呼出氣一氧化氮與白三烯水平相關(guān)性進(jìn)行分析。所得數(shù)據(jù)應(yīng)用SPSS23.0軟件進(jìn)行統(tǒng)計學(xué)分析。結(jié)果:1.在符合納入標(biāo)準(zhǔn)的108例患兒中,學(xué)齡組共39例,占總例數(shù)的36%,學(xué)齡前共69例,占總例數(shù)的64%。UACS患兒中學(xué)齡前組患兒多于學(xué)齡組患兒。2.在符合納入標(biāo)準(zhǔn)108例UACS患兒中,UACS患兒中單一病因多于二重以上(包括二重病因),占57.4%。其中接受鼻竇CT檢查者共59例,其中確診鼻竇炎的患兒45例,占76.3%,鼻竇未見明顯異常者14例,占23.7%。鼻竇CT異常者明顯多于鼻竇CT正常者,占76.3%。3.符合納入標(biāo)準(zhǔn)的108例UACS患兒中完成血清白三烯檢測的共62例,UACS患兒中血清白三烯異常者多于血清白三烯正常者,占81.2%。符合納入標(biāo)準(zhǔn)的108例UACS患兒中完成FeNO檢測的共89例,UACS患兒中FeNO異常者多于FeNO正常者,占61.2%。符合納入標(biāo)準(zhǔn)的108例UACS患兒中完成NNO檢測的共86例,其中鼻塞組共32例,占37.2%,非鼻塞組共54例,占62.8%。兩組的nNO結(jié)果經(jīng)獨立樣本t檢驗,鼻塞組患兒nNO濃度小于非鼻塞組患兒nNO濃度,P0.05,差異性具有統(tǒng)計學(xué)意義。4.在符合納入標(biāo)準(zhǔn)的108例UACS患兒中,其中均能夠有效完成nNO檢測與血清白三烯的患兒有31例,兩者經(jīng)Spearman相關(guān)檢驗,兩者具有正相關(guān)性,P0.05,具有統(tǒng)計學(xué)意義;在符合納入標(biāo)準(zhǔn)的108例UACS患兒中,均能夠有效完成血清白三烯與FeNO檢測的患兒有50例,兩者經(jīng)Spearman相關(guān)檢驗,兩者具有正相關(guān)性,P0.05,具有統(tǒng)計學(xué)意義;在符合納入標(biāo)準(zhǔn)的108例UACS患兒中,其中均能夠有效完成nNO與FeNO檢測的患兒有44例,兩者進(jìn)行Spearman相關(guān)檢驗,兩者具有正相關(guān)性,P0.05,具有統(tǒng)計學(xué)意義。結(jié)論:1.在UACS患兒中,2/3的患兒為學(xué)齡前期,多以單一因素為主。2.UACS患兒nNO、FeNO、血清白三烯水平均有不同程度的升高;nNO水平無鼻塞者明顯高于有鼻塞者,鼻塞可以影響患兒鼻部炎癥水平的評估,需經(jīng)過對癥治療,鼻塞癥狀緩解后再次進(jìn)行鼻部氣道炎癥水平的監(jiān)測。3.UACS患兒血清白三烯水平與氣道炎癥水平呈正相關(guān),UACS患兒nNO水平、FeNO水平呈正相關(guān)。
[Abstract]:Objective: to investigate the clinical characteristics of upper airway cough syndrome and the relationship between the level of serum inflammatory mediators and the level of airway inflammation in order to explore the possibility of radiation substitution and traumatic examination. Methods: retrospective analysis was used to select the outpatient clinic of chronic cough in Dalian Children's Hospital from September 2014 to February 2017, with the exception of recent respiratory infections, and to provide clinical basis for the diagnosis and treatment of upper airway cough syndrome. Patients with chronic cough caused by other causes, congenital respiratory malformation, and immune dysfunction were treated with clinical symptoms, nasal sinus CT findings, level of nitric oxide (no) exhaled in the airway, which met the diagnostic criteria of upper airway cough syndrome in children. The serum leukotriene level was analyzed and summarized, and the correlation between nitric oxide and leukotriene level in airway exhalation was analyzed. The data were statistically analyzed by SPSS23.0 software. Results: 1. Among 108 children who met the inclusion criteria, There were 39 cases in the school-age group, accounting for 36% of the total cases, 69 cases in the preschool group, 64% of the total number of patients with UACS was more than that of the school-age group. 2. Among the 108 children who met the inclusion criteria, the single cause of UACS was more than double (including double etiology, 57.4%). 59 of them underwent CT examination of paranasal sinuses. Among them, 45 cases (76.3%) were diagnosed as sinusitis, 14 cases (23.7m) had no obvious abnormality in paranasal sinusitis, the number of abnormal CT in paranasal sinus was significantly higher than that of normal CT in paranasal sinusitis. There were 62 children with UACS whose serum leukotrienes were abnormal than those with normal serum leukotriene. 81.2.Among the 108 patients with UACS who met the inclusion criteria, 89 patients with FeNO were more abnormal than those with normal FeNO, accounting for 61.2%. 86 of the 108 UACS children who met the inclusion criteria completed NNO detection, including 32 in the nasal congestion group. There were 54 cases in the non-nasal congestion group, accounting for 62.8%. The nNO concentration in the nasal congestion group was lower than that in the non-nasal congestion group (P 0.05), and the difference was statistically significant (P < 0.05). Among the 108 UACS children who met the inclusion criteria, the nNO concentration in the nasal congestion group was lower than that in the non-nasal congestion group (P 0.05). There were 31 children who were able to complete nNO detection and serum leukotriene effectively, both of them had positive correlation (P 0.05) by Spearman correlation test, and there were significant differences among 108 children with UACS who met the inclusion criteria. There were 50 children with serum leukotriene and FeNO, both of whom had positive correlation (P 0.05) by Spearman correlation test, and there were significant differences among 108 children with UACS who met the inclusion criteria. There were 44 children who were able to test nNO and FeNO effectively. They were tested by Spearman correlation test, which had a positive correlation (P 0.05). Conclusion: 1. 2 / 3 of children with UACS were pre-school children, and there was no significant difference between the two groups (P < 0. 05, P 0. 05, P 0. 05, P 0. 05, P < 0. 05). The level of serum leukotriene in children with UACS was significantly higher than that in patients without nasal congestion, and nasal congestion could affect the assessment of inflammation in children's nose, and needed to be treated with symptomatic treatment. The level of nasal airway inflammation was monitored again. 3. The level of leukotriene in serum was positively correlated with the level of airway inflammation. There was a positive correlation between the levels of nNO and FeNO in UACS children.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R725.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前7條

1 鄒宇;麥飛;黃亞萍;劉漪;陳治鑫;郭良芬;鄧夢夏;;口、鼻呼出氣一氧化氮在兒童鼻部炎性疾病中的應(yīng)用[J];武漢大學(xué)學(xué)報(醫(yī)學(xué)版);2016年05期

2 劉字;謝建紅;;兒童上氣道咳嗽綜合征的臨床特點與對癥治療[J];臨床醫(yī)學(xué)工程;2014年08期

3 王長征;;上氣道咳嗽綜合征的診斷與治療[J];中國臨床醫(yī)生;2014年07期

4 嚴(yán)能兵;羅鴻;;白三烯的研究進(jìn)展與臨床意義[J];國際檢驗醫(yī)學(xué)雜志;2014年06期

5 李延忠;王巖;張慶慧;;細(xì)胞黏附分子及一氧化氮合酶在變應(yīng)性鼻炎鼻黏膜中的表達(dá)[J];臨床耳鼻咽喉科雜志;2006年07期

6 王茂鑫,李志春,張榕,易自翔;慢性鼻竇炎鼻息肉伴發(fā)嗅覺障礙病人iNOS在嗅粘膜中的表達(dá)[J];中國耳鼻咽喉顱底外科雜志;2003年04期

7 張羅;羅雪瑞;劉承耀;趙巖;韓德民;;健康成人口鼻呼出氣一氧化氮含量測定及其影響因素分析[J];中華耳鼻咽喉頭頸外科雜志;2009年04期

，

本文編號：1586809