The Correlation Between Exhaled Nitric Oxide And Asthma Control In Asthmatic Children

Asthma is a worldwide chronic airway inflammatory disease that hasattracted more and more attentions because of its increasing incidenceand mortality rate. To make the diagnostic of asthma, we have to collectmany information include wheezing history, the response to drug therapy,at the same time exclude other diseases. During the management ofasthma, we did not found a good tool so far. The World HealthOrganization (WHO) promote global initiatives of asthma (GINA) toprevent and control asthma, but by now,19years passed, we still have alot of problems not conquered. With the deepening of research, newtheory, new methods and new drugs are emerging, guidelines formanagement asthma has been updated several times. Exhaled nitric oxide(eNO) as a reflection of the airway inflammation, more and moreattention was focused.Research on exhaled nitric oxide (eNO) has been more than20yearsof history. It was found that people and animals exist endogenous nitricoxide (NO) in1991, and eNO elevated in patients with asthma in1993.More and more research about eNO and asthma has been reported.Exhaled nitric oxide has been recognized by NAEPP, GINA and manyother asthma management guidelines, including the official clinicalapplication guide published by the American Thoracic Society in May 2011further affirmed the value of exhaled nitric oxide in asthmadiagnosis and management. The treatment of asthma GINA proposed inorder to achieve and maintain total control, and we are lack of objectiveindex to evaluate the degree of asthma control. Exhaled nitric oxide asindicator reflects airway inflammation, the relationship between whichand asthma control is the purpose of our research.Objective: To investigate the correlation between exhaled nitric oxideconcentration and levels of asthma control, and compared with thepulmonary function, further evaluation of the significance of eNO inasthma control.Subjects and methods: We select the asthma patients who visit ourhospital during2010September to2012September. The entire asthmapatient accorded with the guideline of asthma which established byChinese medical association in2008. We make a strict inclusion andexclusion criteria. Selected cases test eNO and pulmonary functiontesting. By using ACT or C-ACT scale to estimate asthma control level.We collected patient’s name, age and sex, height, weight and other basicinformation. In accordance with the ACT or C-ACT of the selectedpatients were divided into three groups, the number of benchmark caseswith the least case group, more than this number of groups wererandomly selected group. A total of267cases during screening conformto the standard of171cases, the full controlled group60cases, parted controlled group75cases, miss controlled group36cases, so each groupfind out36cases by random. All the data received was processed byusing the statistical analysis software package SPSS18.0. For the generalclinical data, including age, gender and other parameters of statisticalanalysis, the data of the three groups were compared to two by two.Comparison of measurement data, by using variance analysis;comparison of count data, by χ2test, there were significant differences inP<0.05.Results:1. Cases in the three groups have no difference in age, gender, theyare comparable.2. Full controlled compared with partly controlled group, the fullcontrolled group of FEV1%[completely (87.92±11.58)%compared withthe control group [(65.18±14.62)%was significantly increased (P <0.05), partly controlled group eNO[(18.04±10.17) ppb] the missingcontrolled group [(61.18±32.97) ppb] was significantly lower (P <0.05).3. Full control group compared with the non-control group, fullycontrol FEV1%of the group [(89.39±11.01)%] compared with notcontrol group [(47.74±11.80)%] was significantly increased (P0.05),fully control group of eNO [(18.04±10.17) ppb] than that the controlgroup [(85.84±36.05) ppb] was significantly lower (P <0.05). 4. Part of the control group and the non-control group comparison,FEV1%of the part of the control group [(65.18±14.62)%] comparedwith not control group [(47.74±11.80)%] was significantly increased (P<0.05), part of the control group ENO [(61.18±32.97) ppb] than that thecontrol group [(85.84±36.05) ppb] was significantly lower (P <0.05).5. There is negatively correlated between eNO and FEV1.Conclusion:1. Exhaled nitric oxide concentrations associated with asthma controllevel can be used to evaluate asthma control index.2. The pulmonary function in FEV1associated with asthma controllevel can be used to evaluate the level of asthma control.3Exhaled nitric oxide concentrations were negatively correlated withFEV1, but the individual results have been variable.4Exhaled nitric oxide values varied greatly, with FEV1combined tomore accurately assess the level of asthma control.