Elevated fractional exhaled nitric oxide (FeNO) is a clinical indicator of uncontrolled asthma in children receiving inhaled corticosteroids

摘要

Objective: Our study aims to explore the correlation between fractional exhaled nitric oxide (FeNO) and inhaled corticosteroids (ICS) efficacy in childhood bronchial asthma (BA). Methods: 247 pediatric BA patients were selected and divided into 3 treatment groups based on drug therapy: treatment group 1 (seretide, n = 86), treatment group 2 (budesonide, n = 79), and treatment group 3 (salbutamol, n = 82). Another 90 healthy children were recruited as control group. FeNO, FEV1%pred, FEV1/ FVC, MEF25%, MEF50% and PEF%, total serum IgE, EOS%, induced sputum EOS% and supernatant inflammatory indexes (ECP, IL-8, and TNF-alpha) of sputum, ECP, IL-8 and TNF-alpha were detected. Results: Compared with pretreatment, 6 months posttreatment, FeNO, induced sputum EOS%, supernatant inflammatory indexes decreased (all p < 0.05), but pulmonary function indexes and childhood asthma control test (C-ACT) increased in treatment groups (all p < 0.05). FeNO, induced sputum EOS%, and supernatant inflammatory indexes in treatment group 1 were lower than those in treatment group 2 and 3 (all p < 0.05); total serum IgE and peripheral blood EOS% in treatment group 1 and 2 were lower but pulmonary function indexes were higher than those in treatment group 3 (all p < 0.05); according to Pearson correlation analysis, in both ICS and non ICS groups, FeNO was positively correlated to ECP but negatively to C-ACT. Conclusion: ICS is effective in BA treatment, and FeNO associated with ICS efficacy is an indicator for BA intervention. FeNO combing with pulmonary function indexes had a predictive value in BA response.