本文選題：呼出氣一氧化氮 + 哮喘��； 參考：《上海交通大學(xué)》2014年碩士論文

【摘要】：第一部分：呼出氣一氧化氮影響因素分析 目的：呼出氣一氧化氮（FeNO）可用于檢測(cè)哮喘的氣道炎癥，本研究旨在探討FeNO對(duì)于兒童哮喘診斷的應(yīng)用價(jià)值，并對(duì)其影響因素進(jìn)行分析。 方法：收集2012年6月份至2013年6月份來我院就診的哮喘患兒1068例和健康對(duì)照患兒210例，進(jìn)行相關(guān)病史的采集、FeNO檢測(cè)，，應(yīng)用兩獨(dú)立樣本t檢驗(yàn)分析法比較哮喘患兒及健康對(duì)照患兒間FeNO值的差異，并應(yīng)用一元線性相關(guān)與回歸相關(guān)分析法分析FeNO值與哮喘影響因素的相關(guān)性。 結(jié)果：（1）哮喘兒童FeNO值為（24.74±22.72）PPB，健康對(duì)照組FeNO值平均為（11.88±8.25）PPB，哮喘兒童的FeNo值較健康對(duì)照兒童顯著升高（P0.05）。（2）哮喘及健康對(duì)照兒童的FeNO值均與年齡、體重、身高、體表面積呈正相關(guān)，但與濕疹等皮膚過敏史、其他系統(tǒng)疾病過敏史、家族過敏史無相關(guān)性；其中哮喘兒童的FeNO值與變應(yīng)性鼻炎史、現(xiàn)存變應(yīng)性鼻炎、長期控制用藥相關(guān)。（3）哮喘兒童的FeNO值與一周內(nèi)激素及孟魯斯特鈉的使用、哮喘外其他現(xiàn)存過敏性疾病無相關(guān)性。 結(jié)論：哮喘兒童的FeNO值顯著高于健康對(duì)照兒童，并與年齡、身高、體重、變應(yīng)性鼻炎存在相關(guān)性，可作為診斷哮喘的參考依據(jù)。 第二部分：呼出氣一氧化氮與病情及哮喘亞型的相關(guān)性研究 目的：本研究旨在探討呼出氣一氧化氮（FeNO）與兒童哮喘的亞型及病情的相關(guān)性。 方法：選取2012年6月份至2013年9月份我院門診3歲到14歲確診為哮喘患兒共計(jì)1068例，根據(jù)哮喘亞型分為哮喘組、咳嗽變異性哮喘組。根據(jù)相關(guān)臨床表現(xiàn)，哮喘組進(jìn)一步分為控制組、部分控制組、未控制組；咳嗽變異性哮喘組分為分為控制組、未控制組。均進(jìn)行個(gè)人史、家族史、鼻炎史、用藥史等相關(guān)病史采集，及FeNO檢測(cè)，應(yīng)用單因素方差分析比較不同亞型的哮喘兒童間FeNO值的差異，及不同病情的哮喘患兒間FeNO值的差異。 結(jié)果：(1)哮喘組中控制組、部分控制組、未控制組的FeNO值差異顯著高于健康對(duì)照兒童（控制組20.03±17.95PPB，部分控制組28.05±23.40PPB，未控制組42.77±33.53PPB，P0.05）；哮喘組中合并持續(xù)性變應(yīng)性鼻炎者的FeNO值為33.09±29.20PPB，較無鼻炎史者（22.19±18.63PPB）及間歇鼻炎者（24.00±22.63PPB）顯著升高（P0.05）。(2)咳嗽變異性哮喘兒童的FeNO值較健康對(duì)照兒童明顯增高（P0.05），并與用藥相關(guān)；其中控制組和未控制組間差異顯著。(3)咳嗽變性哮喘控制組的FeNO值較哮喘控制組顯著降低。 結(jié)論：FeNO可用于區(qū)分不同亞型的哮喘，及控制、部分控制、未控制等不同病情的轉(zhuǎn)歸。FeNO與用藥、年齡、變應(yīng)性鼻炎等因素相關(guān)，還可作為哮喘治療效果的良好參考依據(jù)。 第三部分：呼出氣一氧化氮與哮喘兒童肺功能的相關(guān)性分析 目的：哮喘是一種可引起氣道阻塞的慢性氣道炎癥，而呼出氣一氧化氮（FeNO）是氣道炎癥的重要指標(biāo)之一。本研究旨在比較哮喘兒童FeNO與肺功能各項(xiàng)指標(biāo)的相關(guān)性，從而明確FeNO對(duì)于氣道阻塞的診斷價(jià)值。 方法：將2013年6月份至2013年9月份來我院哮喘�？崎T診就診的哮喘患兒共計(jì)1011例，采用納庫侖呼氣分析儀及耶格肺功能檢測(cè)儀器檢測(cè)FeNO及肺功能FEV1、FVC、PEF、PEF25、PEF50、PEF75、MMEF等指標(biāo)，應(yīng)用一元線性相關(guān)與回歸分析法分析FeNO與各項(xiàng)肺功能指標(biāo)相關(guān)性。 結(jié)果：（1）1011例哮喘兒童FeNO值為（24.84±23.00）PPB，與肺功能各項(xiàng)指標(biāo)FEV1、FVC、PEF、PEF25、PEF50、PEF75、MMEF皆存在線性相關(guān)性；（2）FeNO與兒童哮喘的大氣道肺功能指標(biāo)FEV1、FVC、PEF呈線性負(fù)相關(guān)；（3）FeNO與兒童哮喘的小氣道肺功能PEF25、PEF50、PEF75、MMEF呈線性負(fù)相關(guān)。 結(jié)論：FeNO與兒童哮喘的大氣道、小氣道肺功能皆成線性負(fù)相關(guān)，在一定程度上反映了氣道阻塞程度。
[Abstract]:Part I: analysis of factors affecting exhaled nitric oxide
Objective: exhalation of nitric oxide (FeNO) can be used to detect airway inflammation in asthma. The purpose of this study is to explore the application value of FeNO in the diagnosis of childhood asthma and to analyze its influencing factors.
Methods: 1068 children with asthma and 210 healthy controls were collected from June to June 2013 in our hospital. The related medical history was collected, FeNO was detected by FeNO, and the difference of FeNO values between children with asthma and healthy controls was compared with the two independent sample t test analysis, and a linear correlation and regression correlation analysis was used. The correlation between the FeNO value and the influencing factors of asthma was analyzed.
Results: (1) the FeNO value of the asthmatic children was (24.74 + 22.72) PPB, the average FeNO value of the healthy control group was (11.88 + 8.25) PPB, the FeNo value of the asthmatic children was significantly higher than that of the healthy control children (P0.05). (2) the FeNO values of the children with asthma and health control were all positively correlated with age, weight, body height and body surface area, but the allergy history of eczema and other systems The history of disease allergy and family allergy is not related; the FeNO value of asthmatic children is associated with the history of allergic rhinitis, existing allergic rhinitis, and long-term control of medication. (3) the FeNO value of asthmatic children is not related to the use of hormone and montelukast sodium in one week, and other existing allergic diseases outside asthma.
Conclusion: the FeNO value of children with asthma is significantly higher than that in healthy control children, and has a correlation with age, height, weight and allergic rhinitis, which can be used as a reference for diagnosis of asthma.
The second part: correlation between exhaled nitric oxide and disease and asthma subtypes.
Objective: To investigate the correlation between exhaled nitric oxide (FeNO) and the subtypes of asthma in children.
Methods: from June 2012 to September 2013, 1068 cases of asthma were diagnosed in our hospital from 3 to 14 years old. According to the asthma subtype, the asthma group was divided into asthma group and cough variant asthma group. According to the related clinical manifestations, the asthma group was further divided into control group, partial control group and uncontrolled group, and the cough variant asthma group was divided into control group. The individual history, family history, the history of rhinitis, the history of rhinitis and the history of drug use were collected, and FeNO tests were carried out. The difference of FeNO values among children with different subtypes of asthma and the difference of FeNO between different asthma children were compared with the single factor analysis of variance.
Results: (1) the FeNO values of the control group in the asthma group and the control group were significantly higher than those in the control group (20.03 + 17.95PPB in control group, 28.05 + 23.40PPB in control group, 42.77 + 33.53PPB in uncontrolled group, P0.05), and 33.09 + 29.20PPB in the patients with persistent allergic rhinitis in the asthmatic group, and 22.1 (22.1). 9 + 18.63PPB) and intermittent rhinitis (24 + 22.63PPB) significantly increased (P0.05). (2) the FeNO value of children with cough variant asthma was significantly higher than that of the healthy control children (P0.05), and was related to the drug use, and the difference between the control group and the uncontrolled group was significant. (3) the FeNO value of the cough variant asthma control group was significantly lower than that of the asthma control group.
Conclusion: FeNO can be used to distinguish different subtypes of asthma, and control, control, uncontrolled and uncontrolled changes of.FeNO with drugs, age, allergic rhinitis and other factors, and can also be used as a good reference for the treatment of asthma.
The third part: correlation between exhaled nitric oxide and lung function in asthmatic children.
Objective: asthma is a chronic airway inflammation that can cause airway obstruction, and exhalation of nitric oxide (FeNO) is one of the important indicators of airway inflammation. The purpose of this study is to compare the correlation between FeNO and various indexes of lung function in asthmatic children, so as to determine the value of FeNO in the diagnosis of airway obstruction.
Methods: a total of 1011 asthmatic children from June 2013 to September 2013 were treated for asthma. FeNO and lung function FEV1, FVC, PEF, PEF25, PEF50, PEF75, MMEF and other indexes were detected by the nancoulomb breath analyzer and the instrument of the lung function test. The single linear correlation and regression analysis was used to analyze FeNO and various lung functions. Can be index correlation.
Results: (1) the FeNO value of 1011 asthmatic children was (24.84 + 23) PPB, and there were linear correlation with various indexes of lung function FEV1, FVC, PEF, PEF25, PEF50, PEF75, MMEF, and FeNO and FEV1, FVC and negative correlation with the lung function index of the large airway in children with asthma. (3) There is a negative correlation between sex.
Conclusion: FeNO is negatively correlated with airway function and small airway function in children with asthma, to a certain extent, reflects airway obstruction.
【學(xué)位授予單位】：上海交通大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R725.6

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