变应性鼻炎与呼出气一氧化氮水平相关性研究

Study on the Correlation between Allergic Rhinitis and Exhaled Nitric Oxide Levels

摘要: 目的：探讨粉尘螨皮肤点刺试验(Skin prick test, SPT)阳性的变应性鼻炎患者口鼻呼出气一氧化氮与鼻部症状评分之间的相关性。方法：选取2021年9月至2022年7月在重庆医科大学附属永川医院行粉尘螨SPT阳性患者358例以及同期同年龄阶段的粉尘螨SPT阴性的非变应性鼻炎患者180例，按照年龄分为儿童组(6~17岁)，青年组(18~40岁)，中老年组(>40岁)；按照粉尘螨皮肤点刺试验分为阴性(−)组，阳性(+~++)组和强阳性(+++~++++)组。检测所有对象的口鼻呼出气一氧化氮值，并对变应性鼻炎患者进行鼻部症状评分，采用SPSS27.0分析各指标的相关性及诊断效能。结果：在不同年龄阶段，变应性鼻炎患者nNO、FeNO值均不同，且较非变应性患者升高，差异具有统计学意义(P < 0.05)。在各个年龄阶段，不同程度的变应性鼻炎患者的nNO无明显差异；SPT为阴性组和阳性组的患者FeNO无明显差异，而强阳性组的患者FeNO在不同年龄阶段具有差异(P < 0.05)，差异具有统计学意义。Spearman相关分析结果显示，儿童组AR患者nNO、FeNO与部分鼻部症状呈弱相关，青年组及中老年组AR患者与鼻部症状评分无明显相关性。结论：FeNO与nNO作为AR诊断的客观指标具有一定的价值，但FeNO与nNO作为评判AR患者严重程度的指标还有待进一步研究。

Abstract: Objective: To explore the correlation between oral and nasal exhaled nitric oxide and nasal symp-tom scores in patients with allergic rhinitis who tested positive for Skin prick test (SPT). Methods: A total of 358 patients with mite SPT-positive and 180 patients with mite SPT-negative non-allergic rhinitis at the same age were selected from Yongchuan Hospital Affiliated to Chongqing Medical University from September 2021 to July 2022, and divided into children group (6~17 years old), youth group (18~40 years old) and middle-aged and elderly group (>40 years old) according to age. According to the skin pricking test of dust mite, they were divided into negative (−) group, positive (+~++) group and strong positive (+++~++++) group. The oral and nasal exhaled nitric oxide values of all subjects were detected, and the nasal symptoms of patients with allergic rhinitis were scored. SPSS27.0 was used to analyze the correlation and diagnostic efficacy of each index. Results: At dif-ferent ages, the nNO and FeNO values of allergic rhinitis patients were different, and higher than those of non-allergic patients, the difference was statistically significant (P < 0.05). There was no significant difference in nNO among patients with different degrees of allergic rhinitis at all ages. There was no significant difference in FeNO between patients with SPT in negative group and posi-tive group, while FeNO in patients with strong positive group was different at different ages (P < 0.05), and the difference was statistically significant. Spearman correlation analysis showed that nNO and FeNO were weakly correlated with some nasal symptoms in AR patients in children group, while there was no significant correlation between AR patients in youth group and middle-aged and elderly group and nasal symptoms score. Conclusion: FeNO and nNO have certain value as objective indicators in the diagnosis of AR, but FeNO and nNO as indicators to evaluate the severity of AR pa-tients need to be further studied.