ASSOCIATION BETWEEN FRACTION OF EXHALED NITRIC OXIDE AND SPIROMETRY DATA AND CLINICAL CONTROL OF ASTHMA IN CHILDREN AND ADOLESCENTS

ABSTRACT Objective: To evaluate the association between fraction of exhaled nitric oxide (FeNO) values and forced expiratory volume in the first second (FEV1) and the level of asthma control, as proposed by the Global Initiative for Asthma (GINA), in asthmatic children and adolescents attended at the National Institute of Women, Children and Adolescents Health Fernandes Figueira of Fundação Oswaldo Cruz (IFF/FIOCRUZ). Methods: This was a cross-sectional study, with a review of medical records of 90 asthmatics between 7 and 17 years old, who were followed up at the IFF/FIOCRUZ Asthma Outpatient Clinic and were referred to perform respiratory function tests (RFT)between March 2013 and September 2014. After classification according to GINA, patients performed complete spirometry and FeNO measurement. Subsequently, they were separated into two groups: regular and non-regular inhaled corticosteroid (ICS) use, regardless of the ventilatory pattern in spirometry. Results: The association between FEV1 values and the degree of asthma control according to GINA (p=0.001) was observed in all patients, regardless of ICS use, but there was no association between FEV1 and levels of FeNO. Conclusions: The correlation observed between GINA and FEV1 reinforces the importance of spirometry in the clinical follow-up of these patients. Although no association was found between the value of FeNO and the degree of asthma control and FEV1, FeNO may be an early method to detect airway inflammation, even before the symptoms and spirometric changes.

摘要 目的：评估巴西奥斯瓦尔多·克鲁兹基金会费尔南德斯·菲格雷拉妇女、儿童与青少年健康国家研究所（IFF/FIOCRUZ）接诊的哮喘儿童及青少年的呼出气一氧化氮分数（fraction of exhaled nitric oxide, FeNO）、第一秒用力呼气容积（forced expiratory volume in the first second, FEV1）与全球哮喘防治创议（Global Initiative for Asthma, GINA）提出的哮喘控制水平之间的关联。方法：本研究为横断面研究，回顾了2013年3月至2014年9月间在IFF/FIOCRUZ哮喘门诊随访、并被转诊行呼吸功能检查（respiratory function tests, RFT）的90名7至17岁哮喘患者的病历资料。所有患者先依据GINA标准进行分类，随后完成完整肺量测定及FeNO检测。之后根据吸入性糖皮质激素（inhaled corticosteroid, ICS）使用是否规律将患者分为两组，不考虑肺量测定的通气模式。结果：所有患者中，无论是否规律使用ICS，FEV1值与GINA哮喘控制程度均存在显著关联（p=0.001），但未观察到FEV1与FeNO水平间存在关联。结论：GINA哮喘控制分级与FEV1之间的相关性进一步证实了肺量测定在此类患者临床随访中的重要性。尽管未发现FeNO值与哮喘控制程度及FEV1之间存在关联，但FeNO或可成为在出现症状及肺量测定异常前，早期检测气道炎症的手段。