Clinical characteristics analysis of small airway dysfunction in children with asthma
10.3760/cma.j.issn.1673-4912.2024.12.007
- VernacularTitle:小气道功能障碍哮喘儿童临床特征分析
- Author:
Haowei CHEN
1
;
Zelin WENG
;
Youjia XU
Author Information
1. 广州中医药大学第二临床医学院510405
- Publication Type:Journal Article
- Keywords:
Asthma;
Small airway dysfunction;
Concentration of alveolar nitric oxide;
Fractional exhaled nitric oxide;
Airway inflammation
- From:
Chinese Pediatric Emergency Medicine
2024;31(12):915-919
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics of small airway dysfunction（SAD）in children with asthma and the diagnostic value of fractional exhaled nitric oxide(FeNO) and alveolar nitric oxide (CaNO) as non-invasive indicators of airway inflammation for SAD.Methods:The informations of children with asthma who were admitted to Department of Pediatrics at the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from March 2023 to February 2024 were collected.The children were divided into SAD group and non-SAD group.The clinical characteristics,eosinophil count,total IgE value,pulmonary function parameters,FeNO value and CaNO value between two groups were compared.The diagnostic value of CaNO and FeNO for SAD in children with asthma was evaluated by the area under the receiver operating characteristic (ROC) curve.Results:A total of 124 children with asthma were included,with 60 patients in the SAD group and 64 patients in the non SAD group.Compared to children in non-SAD group,children in SAD group had higher age at enrollment,history of exposure to tobacco environment,exercise-induced asthma attack,history of repeated respiratory infections,dust mite allergy,children's asthma control test (C-ACT) score <20,poor compliance,allergic rhinitis symptoms in the past year and atopic dermatitis symptoms in the past year(all P<0.05).However,there were no statistically significant differences in family history of asthma and history of milk allergy between two groups ( P>0.05).The ratio of measured and predicted forced expiratory volume in the first second (FEV1% pred),FEV1/FVC measured and predicted (FEV1/FVC%),measured and predicted peak expiratory flow rate (PEF% pred),measured and predicted instantaneous flow rate at 50% forced expiratory capacity (FEF50% pred),measured and predicted instantaneous flow rate at 75% forced expiratory capacity (FEF75% pred),and measured and predicted maximum mid expiratory flow rate (MMEF% pred) were all lower in the SAD group than those in the non-SAD group,while the inflammatory indicators such as total IgE,eosinophil count,FeNO value and CaNO value were higher in the SAD group(all P<0.001).When CaNO and FeNO were used alone or in combination for the diagnosis of SAD,the areas under the ROC curve (95% CI) were 0.92 (0.87-0.97),0.81 (0.73-0.88),and 0.92 (0.87-0.97),with sensitivities of 88.3%,76.7%,and 75.7%,and specificities of 82.8%,71.9%,and 96.9%,respectively.CaNO was negatively correlated with lung function parameters FEV1% pred,FVC% pred,FEF75% pred,MMEF% pred,FEF50% pred,and FEF75% pred ( P<0.001).CaNO was positively correlated with FeNO ( P<0.001). Conclusion:Patients with SAD have higher levels of inflammatory markers.The non-invasive indicators of airway inflammation has diagnostic and evaluation value for SAD,and the diagnostic efficacy of CaNO is higher than that of FeNO.
