Application Of Fractional Exhaled Nitric Oxide/Bronchial Provocation Test In Asthma Control Assessment

Part1Measurement and Influence factors of Fractional ExhaledNitric Oxide in Healthy ChildrenObjectives This study aimed to establish normal values of FeNO andfind out its influence factors in healthy children age6-14years.Methods The subjects were selected from healthy outpatient of ourhospital and one primary school, their healthy condition was known byhistory taken, pharyngeal portion examination and lung auscultation. FeNOwas measured in those children, along with height, weight, lung ventilationfunction and serum allergen IgE. The results were analyzed with SPSS17.0.statistical software.Results (1)164subjects joined our study,146of them took FeNOexamination successfully, including5suspicious rhinitis patients,7upperrespiratory infection patients and13ones with serum allergen IgE positive.(2) There are61male and60female in those healthy subjects, average age9.4years. Geometric mean FeNO was13.4ppb. There was a significantdifference between6-8years and9-14years(P=0.000). Geometric mean FENO of6-8years was10.3ppb, upper limit of95%reference range was17ppb.9-14years was15.3ppb, upper limit of95%reference range was22ppb. A positive correlation was found between FeNO and age (P=0.000，R=0.528), no correlation had been found between FeNO with sex, height,weight, FEV1%Pred and FEV1/FVC (P＞0.05).(3) Geometric meanFeNO of suspicious rhinitis patients was47.5ppb, much higher than healthysubjects(P=0.000). Geometric mean FeNO of upper respiratory infectionpatients was19.5ppb, still higher than healthy children (P=0.020).Geometric mean FeNO of children with serum allergen IgE positive was28.0ppb, obviously higher than healthy ones(P=0.000), and a strong positivecorrelation was found between FeNO and serum allergen IgE (P=0.000，R=0.893).Conclusion Geometric mean FeNO of healthy children was13.4ppb.There was a significant difference between6-8years and9-14years.Geometric mean FENO of6-8years was10.3ppb, upper limit of95%reference range was17ppb.9-14years was15.3ppb, upper limit of95%reference range was22ppb. A positive correlation was found between FeNOwith age and serum allergen IgE, no correlation found between FeNO withsex, height, weight, FEV1%Pred and FEV1/FVC. FeNO tend to increasewhen children had suspicious rhinitis, upper respiratory infection andallergic condition. Part2Relationship between Fractional Exhaled Nitric Oxidewith Childhood Asthma Control Test and Bronchial Provocation Test inasthmatic childrenObjectives The aim of this work was to find out FeNO in differentasthma control level and the relationship between FeNO with C-ACT andBPT.Methods The study included48asthmatic children who underwentroutine checkups since March2011, through September,2011. The patientscompleted FeNO detection, they also performed pulmonary ventilationfunction, BPT and C-ACT. we analysed those indexes of differentasthma control groups, and tried to find the relationship between them.Results The geometrical mean FeNO of asthmatic children is22.5ppb.Uncontrolled group have higher FeNO than controlled group and partlycontrolled group, FeNO and PC20were both slightly related toFEV1%Pred，but no relevance was found between FeNO, C-ACT and PC20.Conclusion FeNO can be an useful tool in managing asthma togetherwith C-ACT，pulmonary function test and BPT.