Effect Of Atopy On Lung Function And Fractional Exhaled Nitric Oxide In Children With Allergic Rhinitis And Asthma

Object: 1.To explore the effect of atopy and its degree on pulmonary function and FeNO in asthmatic children 2.To explore the effect of asthma with allergic rhinitis on pulmonary function and FeNO in asthmatic childrenMethods: 1.Subjects: The study was conducted from January 2016 to October 2017 in the Asthma specialist clinic of Pediatric department in the Second Hospital of Tianjin Medical University.200 children with asthma chronicity-persistent period and 80 children with allergic rhinitis but without asthma aged 4-12 years old were included in present study.They were divided into atopy group(a-IgE ≥ 60 Ku/L)and non-atopy group(a-IgE < 60 Ku/L)according to a-IgE and simple asthma group,and asthma with rhinitis group according to diagnosis of rhinitis.100 healthy children were included as the control group.2.Indicators: General characteristics : age,sex,height,weight,etc.,allergic history(aeroallergen、food and drug),family history,history of eczema.Serum allergen detection(Including a-IgE \d1\d2\mx2\ex1\i6\wx5\fx5),FeNO,and pulmonary function((FVC,FEV1% predicted,FEV1 / FVC%,PEF% predicted)were collected from all cases 3.Methods: The serum a-IgE and s-IgE were measured by a fluorescence immunoassay analyzer(Phadia 100,Sweden);The pulmonary function were measured by a Pulmonary function test system(Power Cube-Body,Germany).The exhaled Fractional nitric oxide analyzer was used for the examination of FeNO(NIOX VERO,Sweden).4.Statistical analysis: All the data analysis was performed by using spss20.0 statistical software.the measurement variables were described by mean±standard deviation((?)±s),the Kruskal-Wallis chi-square test was used to examine the difference of the count variables.Normal distribution and homogeneity of variance test were examined in measurement variables.Measurement variables of normal distribution were examined by the t-test,measurement variables of non-normal distribution were presented as median(interquartile range)[M(P25-P75)] and were examined by rank sum test when compared between each groups.Correlation analysis was tested by Spearman rank correlation.The statistically difference was considered as P<0.05.Results: 1.General characteristics of the simple asthma group,asthma with rhinitis group,rhinitis group,and normal control group(1)There were no significant statistically difference in gender,age,height,weight,and premature birth history in four groups(P values were all >0.05).(2)The history of eczema positive in the asthma with rhinitis group was significantly more than that in the other three groups(P<0.05).(3)The proportion of family history positive in the asthma with rhinitis group was significantly higher than that in the other three groups(P<0.05).2.Levels of a-IgE,FeNO and Lung Function indicators in simple asthma group,asthma with rhinitis group,rhinitis group,and normal control group(1)The levels of a-IgE in the simple asthma group,asthma with rhinitis group,and rhinitis group were significantly higher than those in the normal control group(P<0.05).FeNO values in the three groups were also significantly higher than those in the normal control group(P=0.001).(2)For lung function indicators,only FEV1/FVC% and PEF % predicted(percentage of predicted PEF)values were statistically significant compared with the normal control group.The FEV1/FVC % and PEF % predicted values of the three groups were significantly lower than the normal control group,respectively,P=0.004 and P=0.001.(3)Pairwise comparisons,FeNO level of in asthma with rhinitis group was higher than that in asthma group,rhinitis group,and control group(P values were all <0.05).3.FeNO levels and lung function in asthmatic children after atopic grouping(1)The median FeNO level in the atopic group was significantly higher than that in the non-atopic group,with a statistically significant difference(H=33.92,P=0.000).The level of FeNO in the atopic group was higher than that of the non-atopic group and the control group(P values were all <0.05).The non-atopic group and the control group showed no diference in FeNO levels(P>0.05).(2)Nodifference was found regarding the median level of FEV1% predicted among the three groups(P>0.05).(3)The median level of FEV1/FVC % did not differ among the three groups(H=4.62,P=0.402).Pairwise comparisons,the median level of FEV1/FVC% in the atopic group was lower than that in the non-atopic group and the control group,and the difference was statistically significant(P values were all <0.05).There was no significant difference in the median FEV1/FVC% between the non-atopic group and the control group(P>0.05).(4)There was no significant difference in the median level of PEF % predicted between the atopic group,the nonatopic group,and the control group(H=1.33,P=0.513).Pairwise comparisons,The median level of PEF% predicted in the atopic group was lower than that in the control group and the non-atopic group,and the difference was statistically significant(P values were all <0.05).There was no statistically significant difference between the non-atopic group and the control group(P>0.05).4.FeNO Levels in Children with asthma after grouing after grouing by degree of atopy:The FeNO median levels in the mild group,the moderate-severe group,and the extremely severe group were statistically significant(H=31.16,P=0.001).Pairwise comparisons,the FeNO level in the extremely severe group was higher than that in the moderate-severe group and the mild group,and the difference was statistically significant(P values were all <0.05).5.FeNO level and pulmonary function in children with rhinitis group after atopic grouping :The level of FeNO in the atopic group was higher than that in the non-atopic group.The difference was statistically significant(H=36.63,P=0.007).There was no significant difference in FEV1% predicted,FEV1 / FVC% and PEF% predicted between the atopic group and the non-atopic group,P values were all >0.05.6.FeNO levels in children with rhinitis group after grouing by degree of atopy:The FeNO median levels in the mild group,the moderate-severe group,and the extremely severe group were significantly different(H=30.15,P=0.002).Pairwise comparisons,the FeNO level in the extremely severe group was higher than that in the moderate-severe group and the mild group,and the difference was statistically significant(P values were all < 0.05).7.FeNO level in allergic rhinitis group according to nasal congestion subgroup: FeNO levels did not differ in children with or without nasal congestion.(H=6.63,P=0.607).Conclusion: 1.The level of FeNO in asthma children was related to the degree of atopy.The levels of FEV1/FVC% and PEF% predicted in asthmatic children with atopy were significantly lower than asthmatic children without atopy.2.Asthma with Allergic rhinitis can affect the lung function of asthmatic children.FeNO levels in asthma with allergic rhinitis children were higher than those in children with simple asthma.FeNO levels in children with allergic rhinitis are related to the degree of atopy.