Analysis Of Correlation Between Fractional Exhaled Nitric Oxide And Endothelin 1 In Wheezing Infants

Objective:The prospective study was conducted in wheezing infants to provide more bases for diagnosis by comparing the differences in general data,history data,and laboratory examination data between first wheezing children,recurrent wheezing children and children without wheezing.By comparing the differences of fractional exhaled nitric oxide?FeNO?of the three groups,it is explored whether FeNO can be used as a predictor of recurrent wheezing risk in children and provide a basis for judging the prognosis.The correlation between FeNO and serum endothelin 1?EDN1?was studied to discuss the correlation between FeNO and airway smooth muscle contraction or airway hyperresponsiveness,and may provide help for clinical treatment.Method:A total of 185 infants with wheezing who were hospitalized in the department of Respiratory and Infectious Diseases of Tianjin Children's Hospital between August 2017 and January 2018 were selected.According to the inclusion criteria and exclusion criteria,a total of 148 cases were included in the study.Subjects were divided into first wheezing group?1 time?and recurrent wheezing group??2times?.Thirty infants who were hospitalized in surgical department for the same period without respiratory symptoms were randomly selected as the control group.Results:By comparing the general data of the first wheezing group,the recurrent wheezing group and the control group,the first wheezing group was younger than the recurrent wheezing group,and the median age in the first wheezing group was 11months,ranged from 6 to 16.5 months.There was no significant difference in gender,height,weight,living area,only child,production method,feeding method,history of eczema,history of allergic rhinitis between groups?P>0.05?.The serum IgE levels in the recurrent wheezing group were higher than those in the first wheezing group?P<0.05?.There was no significant difference in allergen-specific IgE antibodies and tidal pulmonary function between the first wheezing group and the recurrent wheezing group?P>0.05?.A total of 99 asthmatic subjects underwent allergen-specific IgE antibody examinations,of which 87?87.9%?had allergens detected.The top five allergen-specific IgE antibody positive rates were:egg white?33.3%?,milk?32.3%?,molds?32.3%?,cashew nut?30.3%?,trees?22.2%?.FeNO levels in the first wheezing group and recurrent wheezing group were significantly higher than those in the control group?P<0.05?.There was no significant difference in FeNO levels between the first wheezing group and the recurrent wheezing group?P>0.05?.There was no significant difference in eosinophil count?EOS?between groups?P>0.05?.The serum EDN1 levels in the first wheezing group and recurrent wheezing group were higher than those in the control group?P<0.05?.There was no significant difference in the serum EDN1 level between the first wheezing group and the recurrent wheezing group?P>0.05?.There was no statistical significance in Spearman rank correlation analysis between FeNO levels and peripheral blood EOS levels?P>0.05?.Comparing the levels of FeNO and serum EDN1 levels,Spearman rank correlation analysis were statistically significant?P<0.05?.The correlation coefficient was 0.512.Conclusions:1.The wheezing infants for the first time had a young age of onset.The median age was 11 months,ranging from 6 to 16.5 months.2.The levels of serum IgE in the recurrent wheezing group were higher than those in the first wheezing group,which were more prone to IgE-mediated allergic inflammation.3.FeNO is a marker of airway inflammation.FeNO levels in wheezing infants increased,suggesting that there is a certain degree of airway chronic inflammation.4.Serum EDN1 is mainly involved in contraction of airway smooth muscle,serum EDN1levels in wheezing infants are elevated,suggesting that airway fistula exists in wheezing infants,which can further increase airway hyperresponsiveness.5.The first wheezing group with elevated levels of FeNO or serum EDN1 may signal the risk of recurrent wheezing.6.There is a positive correlation between FeNO levels and serum EDN1 levels,suggesting that FeNO levels may be associated with airway hyperresponsiveness.It is recommended that wheezing infants be treated with inhaled glucocorticoids and?₂-agonists.