소아 아토피 천식 환자에서 호기 NO 농도와 천식 조절 점수 및 폐기능검사 결과 사이의 연관성
Relevance of Exhaled Nitric Oxide Levels to Asthma Control Test Scores and Spirometry Values in Children with Atopic Asthma
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초록
목적:FeNO는 천식 환자에서 기도 염증을 반영하는 것으로 알려져 있다. 이 연구에서는 FeNO와 천식 조절 점수 및 폐기능검사 결과 사이의 연관성에 대해 알아보고자 하였다. 방법:아토피 천식으로 진단되고 연구 시작 전 흡입 스테로이드를 최소 1개월 이상 사용하지 않은 8세 이상 16세 미만의 소아 123명을 대상으로 하였다. 8-12세 소아에서는 childhood asthma control test (C-ACT) 점수를 12세 이상의 소아에서는 asthma control test (ACT) 점수를 측정하였으며, 모든 소아에 대해 폐기능검사와 FeNO 측정을 실시하였다. 결과:아토피 천식 소아에서 FeNO의 기하학적 평균 (19.2 parts per billion [ppb]; 95% CI, 17.2-21.4)은 정상 소아들 (7.5 ppb; 95% CI, 7.0-8.0)에 비해 유의하게 높았다.(P<.001) ACT 점수나 C-ACT 점수는 대상군 소아의 82%에서 20점 이상이었으며, %FEV_1, FEV_1/ FVC, %FEF_(25-75)%와 유의한 상관관계를 나타내었다. 그러나 FeNO는 천식 조절 점수나 폐기능검사 결과와 유의한 상관관계를 보이지 않았다. 나이, 성별, 신체질량지수, 또는 부모 흡연 여부에 따른 FeNO의 차이는 관찰되지 않았다. 결론:소아 아토피 천식 환자에서 FeNO는 천식 조절 점수나 폐기능검사 결과와 연관성을 보이지 않았다. 따라서 소아 아토피 천식 환자에서 천식 조절 점수 측정이나 폐기능검사와 함께 기도 염증 정도를 반영하는 FeNO의 측정이 필요하다고 판단된다.
Abstract
Purpose:Fractional exhaled nitric oxide (FeNO) has been proposed as a tool for assessing airway inflammation in patients with atopic asthma. We evaluated the relationship between FeNO with asthma control test (ACT) scores and spirometry values in children with atopic asthma. Methods:One hundred twenty-six children with atopic asthma, 8-16 years of age, were included in the study. None of the participants received regular controller therapy for at least 4 weeks before the study. The ACT (for children >12 years of age) or the Childhood Asthma Control Test (C-ACT; for children between the ages of 8 and 11 years of age), FeNO measurements and pulmonary function tests were performed. Results:: The geometric mean of the FeNO in children with atopic asthma (16.1 parts per billion [ppb]; 95% CI, 14.5-17.8 ppb) was significantly higher than that healthy controls (7.5 ppb; 95% CI, 7.0-8.1 ppb; P<0.001). ACT or C-ACT scores were >20 in 82% of enrolled patients and correlated with the %FEV_1, FEV_1/FVC, and %FEF_(25-75). However, FeNO was not related to %FEV_1, FEV_1/FVC, %FEF_(25-75), and scores for asthma controls. FeNO levels in asthmatic children were not significantly different with respect to age, gender, BMI, and tobacco exposure. Conclusion:FeNO was not related to the spirometry values and scores for asthma control. Measurement of FeNO may be a complementary tool in the assessment of asthma control.
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