Changes In Pulmonary Function,exhaled Nitric Oxide And Interleukin-6 In Children With Asthma At Different Levels Of Control

Objective: To investigate the changes in pulmonary function and exhaled breath nitric oxide and interleukin-6 in children with asthma at different levels of control and their clinical significance.Methods: Ninety-eight children with bronchial asthma who attended the pediatric asthma clinic of the Affiliated Hospital of Chengde Medical College from September 2021 to October 2022 were selected for the study.All study subjects completed the Childhood Asthma Test Questionnaire(c-ACT)under the guidance of a specialist and calculated the scores,which were divided into three groups based on the scores: fully controlled,partially controlled and uncontrolled.The 98 children with asthma were also grouped according to whether interleukin-6(IL-6)was elevated or not,and divided into the group with elevated IL-6(>7 pg/ml)and the group with normal IL-6(≤7 pg/ml).IL-6,C-reactive protein(CRP),white blood cell count(WBC),neutrophil ratio(NEU),eosinophil ratio(EOS),exhaled nitric oxide(FeNO),exertional expiratory volume in the first second(FEV1),and 1-second rate(FEV1/FVC)were collected from the children.To compare the differences of pulmonary function,FeNO and related indexes at different asthma control levels and different groupings,and to understand whether there is any correlation between them,in order to be able to provide clinicians with more diversified methods to judge the level of asthma control and to better guide and adjust the treatment.Results:1.There were no statistically significant differences in clinical baseline information: age,sex,height,weight,and mean disease duration between the different control level subgroups,IL-6 normal and IL-6 elevated groups(P>0.05).2.IL-6,CRP,NEU and EOS were statistically different among the three groups at different control levels(P<0.05),and the indexes were highest in the uncontrolled group,second highest in the partially controlled group,and lowest in the fully controlled group;later,a two-by-two comparison revealed that IL-6,CRP,NEU,and EOS were statistically different between the fully controlled and uncontrolled groups(P<0.05),partial control and uncontrolled groups EOS was statistically different(P<0.05),and IL-6,CRP,NEU,and EOS were not statistically different between the fully controlled and partially controlled groups(P>0.05).There was no statistical difference in WBC between all three groups(P>0.05).3.There were statistical differences in FeNO,FEV1,and FEV1/FVC among the three groups at different control levels(P<0.05).FeNO increased in the fully controlled group,partially controlled group,and uncontrolled group,while FEV1,FEV1/FVC decreased;After comparing the two groups,it was found that there was a statistically significant difference in FeNO between the complete control group and the uncontrolled group(P<0.05).There was a statistically significant difference in FEV1,FEV1/FVC between the complete control group,partial control group,and uncontrolled group(P<0.05).There was no statistically significant difference in FeNO,FEV1,FEV1/FVC between the complete control group and partial control group(P>0.05).4.The complete control rate and partial control rate were significantly higher in the IL-6 normal group than in the IL-6 elevated group,and the uncontrolled rate was significantly lower than in the IL-6 elevated group,all with statistically significant differences(P<0.05).c-ACT score,FEV1,and FEV1/FVC were significantly higher in the IL-6 normal group than in the IL-6elevated group,and FeNO was significantly lower than in the IL-6 elevated group,all with statistically significant(P<0.05).5.Correlation analysis showed that within the uncontrolled group,F EV1 was negatively correlated(P<0.05)with IL-6,NEU,and FeNO(r=-0.353,-0.833,-0.595),and FEV1/FVC was negatively correlated with IL-6,N EU,and FeNO(r=-0.379,-0.847,-0.636)(P<0.05);within the partial contro l group,FEV1 was negatively correlated(P<0.05)with IL-6,NEU,and FeNO(r=-0.587,-0.627,-0.728),and FEV1/FVC was negatively correlated(P<0.05)with IL-6,NEU,and FeNO(r=-0.611,-0.606,-0.750);within the com plete control group,there was no correlation between IL-6,CRP,WBC,NE U,EOS,FeNO and FEV1 and FEV1/FVC(P>0.05).6.The Spaerman correlation analysis showed that CRP was positive ly correlated with FeNO(r=0.368,P<0.001)and negatively correlated wit h FEV1(r=-0.230,P=0.023)and FEV1/FVC(r=-0.269,P=0.007)in all child ren;NEU was negatively correlated with FEV1(r=-0.454,P<0.001)and FEV1/FVC(r =-0.499,P<0.001),and no correlation with FeNO(r=0.193,P>0.05);EOS was positively correlated with FeNO(r=0.284,P=0.005)and positively correlated with FEV1(r=-0.478,P<0.001)and FEV1/FVC(r=-0.496,P<0.001)were negatively correlated.Conclusions:1.FEV1,FEV1/FVC significantly decreased in children with asthm a,and the higher the concentration of FeNO and serum IL-6,CRP,NE U,and EOS,the poorer the asthma control level.2.Lung function measurement,IL-6,CRP,NEU,EOS,and FeNO can respectively reflect airway obstruction and inflammatory levels in th e body,and complement each other.Combined detection can comprehen sively reflect the level of asthma control in children.