Application Of Nasal Nitric Oxide In Allergic Rhinitis With Adenoid Hypertrophy In Children

Objective: To explore the relationship between the concentration of nasal exhalation nitric oxide and the clinical symptom score of allergic rhinitis(AR)with adenoid hypertrophy(AH)in children,and to analyze the relationship between the improvement of clinical symptom score and the change of nasal exhalation nitric oxide concentration after AR with AH treated by quadruple drugs,To investigate the possible objective value and clinical significance of exhaled nitric oxide in children with AR and AH.Methods: 103 children aged 5-14 years old diagnosed as AR with AH in the infantile respiratory asthma Department of Xiangxi Autonomous Prefecture People’s hospital from August 2019 to March2021 were enrolled,According to the degree of adenoid hypertrophy,it was divided into three groups:mild,moderate and severe.Three groups of children were treated with drugs(physiological sea salt water,the second generation of new antihistamines,nasal hormones,montelukast).Meanwhile,the nasal nitric oxide concentrationin,clinical symptom score and A / N were measured before the children treated by quadruple drug,1 month after treatment,3 months after treatment and 6 months after withdrawal.To evaluate and analyze the relationship between the change of nasal nitric oxide concentration and clinical symptom score,as well as adenoids in children with AR and AH treated by quadruple drugs,as well as its clinical significance.Results:(1)Analysis of the effective rate of drugs in the treatment of AR and AH: the effective rate of 1 month in the mild,moderate and severe groups was 93.7%,74.1% and 76.9%,respectively;The effective rates after 3 months were 98.4%,85.2% and 100%,respectively.The total effective rate of the three groups was 86.4% and 95.1% after 1 and 3 months of treatment,respectively.(2)Analysis of the relationship between nNO and AR and AH in different courses: before treatment,nNO in mild,moderate and severe groups were(233.22±115.93 PPB),(231.22±110.51 PPB)and(185.77±137.90PPB),respectively,and there was no difference among the groups(P > 0.05).After 1 month of treatment,the difference of nNO in mild,moderate and severe groups was(22.54± 76.44ppb),(58.00±69.85ppb)and(77.31± 71.31ppb),respectively,with statistical significance(P < 0.05).After 3 months of treatment,the difference of nNO in mild,moderate and severe groups was(52.43±127.89 PPB)(53.30±49.13 PPB)and(85.00±77.52 PPB),respectively,with no difference among the groups(P >0.05).(3)Correlation analysis between nNO and clinical symptom score in different courses of treatment: nNO was negatively correlated with mouth breathing before treatment;After 1 month of treatment,nNO was negatively correlated with snoring.After 3 months of treatment,nNO was negatively correlated with snoring,open-mouth breathing,nasal congestion,nasal itching,restless sleep and total score of clinical symptoms.And all were statistically significant.Conclusion: In the diagnosis and treatment of AR with AH,nNO shows the trend of upward with the decrease of A/N value,which shows the negatively correlated with the clinical symptom score.It can be used as the non-invasive objective index to evaluate the therapeutic efficacy of AR with AH.