Associations of Fraction of Exhaled Nitric Oxide with Beta Agonist Use in Children with Asthma.
Associations of Fraction of Exhaled Nitric Oxide with Beta Agonist Use in Children with Asthma.
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哮喘儿童呼出一氧化氮分数与β受体激动剂使用的关联。
DOI：
10.1089/ped.2010.0047
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发表时间：
2011
期刊：
影响因子：
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通讯作者：
Lanphear,BruceP
中科院分区：
文献类型：
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作者：
Spanier,AdamJ;Kahn,RobertS;Hornung,Richard;Lierl,Michelle;Lanphear,BruceP
呼出一氧化氮 (FeNO) 分数是气道炎症的衡量标准，是指导儿童哮喘管理的潜在无创工具。然而，目前尚不清楚 FeNO 是否添加了哮喘控制临床评估之外的任何信息。我们评估了 FeNO 水平与短效 β 受体激动剂使用的关联，并将其与其他临床哮喘评估进行了比较。我们检查了一项前瞻性队列研究，该研究涉及 225 名 6-12 岁接触烟草烟雾且患有医生诊断为哮喘的儿童，包括 FeNO 测量、报告的短效 β 受体激动剂使用天数以及计划外的哮喘就诊。分析了 FeNO 与当前和未来（3 个月后）短效 β 受体激动剂使用的关系。基线、6 个月和 12 个月时的平均 FeNO 分别为 15.5、15.7 和 16.8ppb。在多变量分析中，较高的 FeNO 水平与短效 β 受体激动剂使用增加相关，但仅限于未使用吸入皮质类固醇的儿童。在那些未使用吸入类固醇的患者中，FeNO 水平每增加 10ppb，当前短效 β 受体激动剂的使用量就会增加 12%，未来的使用量会增加 15%。即使在调整了计划外的哮喘就诊后，FeNO 水平仍然与当前短效 β 受体激动剂的使用相关。即使在调整了当前短效 β 受体激动剂的使用或计划外的哮喘就诊后，FeNO 水平仍然与未来短效 β 受体激动剂的使用相关。我们得出的结论是，FeNO 水平与短效 β 受体激动剂的使用有关，但仅限于未吸入皮质类固醇的儿童。
The fraction of exhaled nitric oxide (FeNO), a measure of airway inflammation, is a potential noninvasive tool to guide asthma management in children. It remains unclear, however, if FeNO adds any information beyond clinical assessment of asthma control. We evaluated the associations of FeNO level with short acting beta agonist use and compared it with other clinical asthma assessments. We examined a prospective cohort study of 225 tobacco-smoke-exposed children aged 6–12 years with doctor-diagnosed asthma, including measures of FeNO, reported days of short acting beta agonist use, and unscheduled asthma visits. FeNO was analyzed in relation to current and future (3 months later) short acting beta agonist use. Mean FeNO at baseline, 6, and 12 months was 15.5, 15.7, and 16.8 ppb. In multivariable analyses, higher FeNO level was associated with increased short acting beta agonist use but only among children who were not on inhaled corticosteroids. Among those not on an inhaled steroid, there was a 12% increase in current and 15% increase in future days of short acting beta agonist use for every 10 ppb increase in FeNO level. FeNO levels remained associated with current short acting beta agonist use even after adjusting for unscheduled asthma visits. FeNO levels remained associated with future short acting beta agonist use even after adjusting for current short acting beta agonist use or unscheduled asthma visits. We conclude that FeNO levels are associated with short acting beta agonist use but only among children who are not on an inhaled corticosteroid.