Related factors for asthmatic children's responses to long-term treatment

LIU Xiao-Ying; WANG Jing; WANG Qun; REN Yi-Xin; LIU Yong-Ge; MIAO Qing; LI Zhen; XIANG Li

doi:10.7499/j.issn.1008-8830.2015.07.010

PDF(1381 KB)

Chinese Journal of Contemporary Pediatrics ›› 2015, Vol. 17 ›› Issue (7) : 692-697. DOI: 10.7499/j.issn.1008-8830.2015.07.010

CLINICAL RESEARCH

Related factors for asthmatic children's responses to long-term treatment

LIU Xiao-Ying, WANG Jing, WANG Qun, REN Yi-Xin, LIU Yong-Ge, MIAO Qing, LI Zhen, XIANG Li

Author information +

History +

Abstract

Objective To study the changes in pulmonary function and fractional exhaled nitric oxide in exhaled breath (FeNO) in asthmatic children who have different responses to regular treatment. Methods A total of 52 asthmatic children who had a good compliance with regular stepped control treatment were selected as subjects. They were followed up every three months to evaluate the asthma control level, pulmonary ventilation function, and FeNO for 9 months. Besides, medications for asthma control were recorded. Results At three follow-up points (months 3, 6, and 9), the percentage of asthmatic children who used the first or the second level of control treatment in the stable group (with stable response to the treatment) was significantly higher than in the unstable group (with unstable response to the treatment) (P<0.05), while the percentage of asthmatic children who used the third level of control treatment in the stable group was significantly lower than in the unstable group (P<0.05). At the three follow-up points, the stable group had a significantly higher ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) than the unstable group (P<0.05); at the 3-month and 9-month follow-up points, the stable group had a significantly higher percentage of predicted maximum mid-expiratory flow (MMEF%) than the unstable group (P<0.05); at the initial evaluation and 3-month follow-up point, the stable group had a significantly higher FeNO than the unstable group (P<0.05). Conclusions Continuously monitoring FEV1/FVC, MMEF% and FeNO is useful in the early evaluation of the responses to treatment in children with asthma.

Key words

Asthma / Pulmonary function / Fractional exhaled nitric oxidein in exhaled breath / Child

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

LIU Xiao-Ying, WANG Jing, WANG Qun, REN Yi-Xin, LIU Yong-Ge, MIAO Qing, LI Zhen, XIANG Li. Related factors for asthmatic children's responses to long-term treatment[J]. Chinese Journal of Contemporary Pediatrics. 2015, 17(7): 692-697 https://doi.org/10.7499/j.issn.1008-8830.2015.07.010

References

[1] Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. 2014(revision)[EB/OL]. URL: http://www.ginasthma.org.
[2] 中华医学会儿科学分会呼吸学组. 儿童支气管哮喘诊断与防治指南[J]. 中华儿科杂志, 2008, 46(10): 745-753.
[3] Bozkurt B, Karakaya G, Kalyoncu AF. Seasonal rhinitis, clinical characteristics and risk factors for asthma[J]. Int Arch Allergy Immunol, 2005, 138(1): 73-79.
[4] Homburger HA. Diagnosing allergic diseases in children. Practical recommendations for consulting pathologists[J]. Arch Pathol Lab Med, 2004, 128(9): 1028-1031.
[5] Beydon N, Davis SD, Lombardi E, et al. An Official American Thoracic Society/European Respiratory Society Statement: Pulmonary Function Testing in Preschool Children [J]. Am J Respir Crit Care Med, 2007, 175(12): 1304-1345.
[6] American Thoracic Society; European Respiratory Society. ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide[J]. Am J Respir Crit Med, 2005, 171(8): 912-930.
[7] 宋立强, 吴昌归, 孙秀珍, 等. 陕西省地区级城市哮喘患者的控制现状及对疾病认知程度的调查[J]. 中国呼吸与危重监护杂志, 2009, 8(4): 351-354.
[8] Thompson PJ, Salvi S, Lin J, et al. Insights, attitudes and perceptions about asthma and its treatment: findings from a multinational survey of patients from 8 Asia-Pacific countries and Hong Kong[J]. Respirology, 2013, 18(6): 957-967.
[9] 全国儿科哮喘协作组. 第三次中国城市儿童哮喘流行病学调查[J]. 中华儿科杂志, 2013, 51(10): 729-735.
[10] 赵京, 柏娟, 申昆玲, 等. 北京、重庆、广州三城市中心城区0 ~14 岁儿童过敏性疾病问卷调查[J]. 中华儿科杂志, 2011, 49(10): 740-744.
[11] de Groot EP, Nijkamp A, Duiverman EJ, et al. Allergic rhinitis is associated with poor asthma control in children with asthma[J]. Thorax, 2012, 67(7): 582-587.
[12] Deliu M, Belgrave D, Simpson A, et al. Impact of rhinitis on asthma severity in school-age children[J]. Allergy, 2014, 69(11): 1515-1521.
[13] Nair SJ, Daigle KL, DeCuir P, et al. The influence of pulmonary function testing on the management of asthma in children[J]. J Pediatr, 2005, 147(6): 797-801
[14] Beydon N. Pulmonary function testing in young children [J]. Paediatr Respir Rev, 2009, 10(4): 208-213.
[15] Bacharier LB, Strunk RC, Mauger D, et al. Classifying asthma severity in children: mismatch between symptoms, medication use, and lung function [J]. Am J Respir Crit Care Med, 2004, 170(4): 426-432.
[16] Simon MR, Chinchilli VM, Phillips BR, et al. Forced expiratory flow between 25% and 75% of vital capacity and FEV1/forced vital capacity ratio in relation to clinical and physiological parameters in asthmatic children with normal FEV1 values [J]. J Allergy Clin Immunol, 2010, 126(3): 527-534.
[17] Mitra AD, Ogston S, Crighton A, et al. Lung function and asthma symptoms in children: relationships and response to treatment[J]. Acta Paediatr, 2002, 91(7): 789-792.
[18] Yao TC, Ou LS, Lee WI, et al. Exhaled nitric oxide discriminates children with and without allergic sensitization in a populationbased study[J]. Clin Exp Allergy, 2011, 41(4): 556-564.
[19] Yamamoto M, Tochino Y, Chibana K, et al. Nitric oxide and related enzymes in asthma: relation to severity, enzyme function and inflammation[J]. Clin Exp Allergy, 2012, 42(5): 760-768.
[20] Benson RC, Hardy KA, Morris CR. Arginase and arginine dysregulation in asthma[J]. J Allergy, 2011, 2011: 736319.
[21] Kercsmar C. Exhaled nitric oxide in the diagnosis and management of childhood asthma[J]. Ther Adv Respir Dis, 2010, 4(2): 71-82.
[22] Prado CM, Yano L, Rocha G, et al. Effects of inducible nitric oxide synthase inhibition in bronchial vascular remodelinginduced by chronic allergic pulmonary inflammation [J]. Exp Lung Res, 2011, 37(5): 259-268.
[23] Franklin PJ, Stick SM. The value of FeNO measurement in asthma management the motion against FeNO to help manage childhood asthma-reality bites[J]. Paediatr Respir Rev, 2008, 9(2): 122-126.
[24] Szefler SJ, Mitchell H, Sorkness CA, et al. Management of asthma based on exhaled nitric oxide in addition to guidelinebased treatment for inner-city adolescents and young adults: a randomised controlled trial[J]. Lancet, 2008, 372(9643): 1065-1072.
[25] Fritsch M, Uxa S, Horak F Jr, et al. Exhaled nitric oxide in the management of childhood asthma: a prospective 6-months study[J]. Pediatr Pulmonol, 2006, 41(9): 855-862.
[26] Spanier AJ, Hornung RW, Kahn RS, et al. Seasonal variation and environmental predictors of exhaled nitric oxide in children with asthma [J]. Pediatr Pulmonol, 2008, 43(6): 576-583.
[27] Busse WW, Pedersen S, Pauwels RA, et al. START Investigators Group. The Inhaled Steroid Treatment As Regular Therapy in Early Asthma (START) study 5-year follow-up: effectiveness of early intervention with budesonide in mild persistent asthma[J]. J Allergy Clin Immunol, 2008,121(5): 1167-1174.
[28] 刘靖, 张晓波, 冯海燕, 等. 影响儿童哮喘尘螨特异性免疫疗效的因素分析[J]. 中国当代儿科杂志, 2013, 15(10): 854-859.