| Objective:This study was to explore the changes of FeNO ana tidal lung function in children with MPP and their correlations with serum MP-IgM titer,by monitoring the values of Nitrogen Oxide(FeNO),tidal lung function(TPTEF/TE、VPEF/VE),and serum MP-IgM titer at different time points of children with mycoplasma pneumoniae pneumonia(MPP).At the same time,this study will tell us whether the effect of azithromycin combined with inhaled corticosteroids is better than that of azithromycin alone?Methods:①102 children with mycoplasma pneumoniae pneumonia infection from the pediatric outpatient and inpatient of the Second Affiliated Hospital of Nanhua University were enrolled,from september 2016 to December 2018.After admission to hospotial,60 children were treated with budesonide combined with azithromycin(group A).The other 42 children were treated with azithromycin alone(group B).Around the same time,56 children from pediatric outpatient health checkups were selected as healthy control group.②All children were monitored the FeNO,tidal lung function(TPTEF/TE,VPEF/VE),antibody of IgM titer in serum against mycoplasma infection,the total score of cough symptoms when at admission,2 weeks after treatment and 4 weeks after treatment.Analyse the relationship between the change of MP-IgM titer and FeNO,tidal lung function in A and B group,individually.③Assess the treating effect of azithromycin combined with inhaled corticosteroids by using the index of FeNO,tidal lung function and the total score of cough symptomsResults:1.The values of FeNO,TPTEF/TE and VPEF/VE in the MPP group were(24±6)ppb,(23.19±5.68)%,(26.12±5.34)%,respectively.And the values of normal control group were(11±4)ppb,(35.56±4.41)%,(35.87±6.39)%.Compared with the normal control group,the level of FeNO in the MPP group was higher(P<0.001).Both the TPTEF/TE and VPEF/VE in the MPP group were lower(P<0.001)2.The results before treatment showed that the IgM titer in serum against mycoplasma pneumoniae were not significantly correlated with the level of FeNO,TPTEF/TE and VPEF/VE.The correlation coefficients were(r=-0.037,r=-0.035,r=-0.042).The correlation was not statistically significant(P>0.05).Correlation analysis was performed between FeNO level and other indicators in the selected children.The correlation coefficient between FeNO level and lung function(TPTEF/TE,VPEF/VE)was(r=-0.120,r=-0.217),and the result didn’t reach statistical significance.But the FeNO level was positively correlated with cough symptom scores.The correlation coefficient was(r=0.472),and the correlation was statistically significant(P<0.05)3.Comparison of FeNO levels before and after treatment:before treatment,2 weeks and 4 weeks after treatment,the FeNO levels in group A were respectively(23±9,11±4,6±5)ppb;the FeNO levels in group B were(21±7,16±6,11±2)ppb,respectively.The FeNO values of A and B groups were both lower than those before treatment,and the decrease was more significant in group A.The difference was statistically significant(P<0.05).The levels of FeNO in group A and group B were both lower than those before treatment,but the decrease of FeNO level was more obvious at 2 weeks after treatment(P<0.05)4.Comparison of tidal pulmonary function before and after treatment(TPTEF/TE,VPEF/VE):before treatment,2 weeks after treatment and 4 weeks after treatment,the levels of TPTEF/TE respectively in group A were(25.4±9.4,35.9±11.8,38.1±14.3)%.The VPEF/VE levels were respectively(27.1±8,37.4±12.8,38.2±13.1)%.The levels of TPTEF/TE before treatment,2 weeks and 4 weeks after treatment were(26.7±8.5,29.4±12.6,36.6±8.7)%in group B.The VPEF/VE levels were(25.3±6,29.5±10.4,35.7±7.3)%,respectively.The TPTEF/TE and VPEF/VE levels in group A and B were both higher than those before treatment.And the difference was statistically significant(P<0.05).In addition,at 2 weeks after treatment,the increase in group A was more obvious,there was statistical difference(P<0.05),and at 4 weeks after treatment,there was no statistically significant difference between the two groups(P>0.05)5.Comparison of the total scores of cough symptoms before and after treatment:before treatment,2 weeks and 4 weeks after treatmen,the scores of cough symptoms respectively in group A were(5.8±0.7,2.8±0.5,1.3±0.2)points,in group B,the scores were(5.2±0.8,3.4±0.6,3.3±0.5)points.The scores of cough symptoms in group A and group B were both lower than those before treatment.And the decrease in group A was more obvious.The difference was statistically significant(P<0.05)The scores of cough symptoms in group A and group B were both lower at 2 weeks and 4 weeks after treatment than those before treatment,but it was more obvious at 2 weeks after treatment.The difference was statistically significant(P<0.05)6.Comparison of IgM titers against mycoplasma before and after treatment:before treatment,2 weeks and 4 weeks after treatment,respectively,the IgM titers in A group were(2.4±0.38,2.5±0.35,2.5±0.34).In B group,they were(2.3±0.23,2.5±0.37,2.5±0.38).There was no significant difference between the two groups(P>0.05).After 2 weeks and 4 weeks of traetment,there was no obvious decrease in the IgM titer against mycoplasma pneumoniae both in the A and B groups.Besides,the difference was not statistically significant(P>0.05).Conclusions:1.The tidal lung function of children with MPP decreased,and the level of FeNO increased,Prompt for airway damage and airway inflammation.2.There is no correlation between tidal lung function,FeNO and MP-IgM titer;The level of FeNO has a good correlation with cough symptom scores,but it has no correlation with tidal lung function.3.Budesonide combined with azithromycin is better than azithromycin alone in improving cough symptom scores,tidal lung function and FeNO. |
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