Exhaled nitric oxide in a population-based study of asthma and allergy in schoolchildren
Exhaled nitric oxide in a population-based study of asthma and allergy in schoolchildren
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DOI：
10.1111/j.1398-9995.2005.00735.x
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发表时间：
2005-04-01
期刊：
影响因子：
12.4
通讯作者：
Alving, K
中科院分区：
文献类型：
--
作者：
Nordvall, SL;Janson, C;Alving, K
呼出的一氧化氮（NO）反映了下呼吸道的炎症，非常适合用于儿童。本研究的目的是调查的分数过期NO（FENO）在学龄儿童的分布，并比较FENO和肺功能测定法在有关的国际研究哮喘和过敏儿童问卷。这项研究在瑞典乌普萨拉随机选择的959名13-14岁的学龄儿童中进行。在0.1 l/s（FENO0.1）的吸入速率下测量呼出的NO，并进行肺活量测定试验，这些测量的数据与问卷调查数据相关。根据美国胸科学会的建议测量呼出的NO，除了使用漱口水和0.1 l/s的呼气流速。FENO0.1平均值的分布是倾斜的，主要是非常低的水平和广泛的尾部值范围高达十亿分之102（ppb）。男孩的FENO 0.1值显著高于女孩，分别为5.2（4.7-5.7）和4.4（4.0-4.8）ppb（几何平均值和95% CI，P < 0.01）。在过去的一年中报告喘息的儿童的FENO0.1值高于未报告喘息的儿童，8.5（7.1-10.2）vs 4.3（4.0-4.6）ppb，P < 0.001）。同样的关联被发现与大多数表明花粉热和湿疹的症状有关。与此相反，只有弱或不一致的协会之间发现哮喘和肺功能指数。呼出的NO水平与男性、喘息和鼻结膜炎独立相关，但与当前湿疹无关。总之，呼出的NO与报告的哮喘和过敏症状密切相关，而肺量测定指标如1秒用力呼气量预测百分比则无关。由于人群中大多数哮喘病例是轻度的，研究结果表明呼出的NO是哮喘和过敏的敏感标志物。
Exhaled nitric oxide (NO) reflects inflammation in the lower airways and is well adapted for use in children. The aims of this study were to investigate the distribution of the fraction of expired NO (FENO) in school children and to compare FENO and spirometry in relation to the International Study of Asthma and Allergies in Childhood questionnaire. The study was performed in 959 randomly selected 13-14-year-old school children in Uppsala, Sweden. Exhaled NO was measured at an inhalation rate of 0.1 l/s (FENO0.1) and a spirometric test was performed and data from these measurements were related to questionnaire data. Exhaled NO was measured according to American Thoracic Society recommendations, except the use of a mouth wash and an exhalation flow rate of 0.1 l/s. The distribution of the mean FENO0.1 values was skewed, with a preponderance of very low levels and a widespread tail of values ranging up to 102 parts per billion (ppb). Boys exhibited significantly higher mean FENO0.1 values than girls, 5.2 (4.7-5.7) vs 4.4 (4.0-4.8) ppb (geometric mean and 95% CI), P < 0.01). Children who reported wheezing in the last year had higher FENO0.1 values than children that had not, 8.5 (7.1-10.2) vs 4.3 (4.0-4.6) ppb, P < 0.001). The same association was found to most symptoms indicating hay fever and eczema. In contrast to this, only weak or inconsistent associations were found between asthma and spirometric indices. Exhaled NO levels were found to be independently related to male gender, wheeze and rhinoconjuctivitis but not to current eczema. In conclusion, exhaled NO was closely associated with reported asthma and allergy symptoms whereas spirometric indices such as percent predicted forced expiratory volume in 1 s were not. As most asthma cases in a population are mild, the findings suggest that exhaled NO is a sensitive marker of asthma and allergy.