The Changes And Clinical Significance Of FeNO Levels In Children With Bronchiolitis

Bronchiolitis is one of the more common lower respiratory tract infections during infants and young children.It occurs mainly in infants younger than 2 years old.The onset peak is 2-6 months.Clinicall performance is coughing,shortness of breath,paroxysmal wheezing,physical examination can find the lungs can be heard and wheeze and wet rales.Mainly caused by the virus infection,the most commom is respiratory syncytial virus.Recent studies have pointed out that children with a history of bronchiolitis in the future are more likely to develop asthma,decreased lung function and airway hyperresponsiveness.The 68% to 92% of children with bronchiolitis will occur again before the age of 3 wheezing,and 30% will develop into asthma.The pathogenesis of bronchiolitis is not very clear.At present,there is a mechanism for the pathogenesis of bronchiolitis,mainly in the Th2 cell subgroup hyperfunction and Th1 cell subsets function is inhibited,it is customary to this Th1 /Th2 drift called Th2 state.This is very similar to most scholars believe that bronchial asthma Th1 / Th2 subgroup imbalance,Th2 hyperthyroidism.This suggests that the two have a certain relevance,but the specific mechanism is not very clear.More and more scholars realize that explore the relationship between bronchiolitis and asthma.2011 American Thoracic Society(ATS)Guide pointed out: In clinical practice,Fe NO can be used as a marker for eosinophilic airway inflammation.In recent years,Fe NO as a noninvasive,simple and easy to assess the evaluation of eosinophilic airway inflammation,more and more attention.Fe NO in the diagnosis of asthma,asthma management and other aspects of the application has a certain value.Therefore,assessing changes in Fe NO levels in bronchiolitis will help us to better understand the pathologic changes of bronchiolitis and the relationship with future wheezing and asthma.Objectives:By determining the changes in Fe NO levels in bronchiolitis,to further understand bronchiolitis and whether to predict future wheezing and asthma.Methods:We enrolled clinical diagnosed bronchiolitis outpatients and inpatients who were treated in Pediatric Respiratory Deparement of the First Bethune Hospital of Jilin University during 2016 january to 2016 December as the research object.Healthy children who accepted health physical examination in the same age group wew selected as the control group.In total,we collected 50 cases of bronchial asthma,50 cases of the control group.We collected the basic information of the patients including ages,and measured the levels of Fe NO.We analyzed all the data by the data by the software SPSS19.0 statistically.Results:1.The levels of Fe NO in the acute phase of children with bronchiolitis were lower than those in the normal group(P <0.05),and there was significant difference between the two groups.2.Bronchitis in children with 3 months review of Fe NO value higher than the normal group of children,P<0.05,the two groups were statistically significant.3.Bronchiolitis in children,in the acute phase and 3 months after the review there was a significant difference,3 months review of the Fe NO value was significantly higher than the acute phase of children,and P <0.05,the two groups were statistically significanConclusion:1.Bronchiolitis in children with acute decline in the level of Fe NO,and lower than the normal control group,the two there is a statistical difference,suggesting that acute bronchiolitis eosinophilic inflammation is not dominant,acute phase may be mainly neutrophils Inflammation.2.Bronchiolitis in children after 3 months of elevated levels of Fe NO,and higher than the control group of normal children,there is a statistical difference between the two,suggesting that eosinophilic inflammation in the late stage of bronchiolitis dominated,indicating that bronchiolitis should be eosinophilic Granulocyte airway inflammation and neutrophil airway inflammation mixed.3.The same group of patients with bronchiolitis at different stages of Fe NO levels are different,acute lower than normal levels.The latter is higher than the normal level,taking into account the inhibition of acute NO production,and then there will be a "rebound effect",not with the virus infection.4.Bronchiolitis acute phase and 3 months after the different levels of Fe NO,although there are two statistical differences,but can not explain the Fe NO for the prediction of the relationship between wheezing and asthma.