氣喘兒童呼出氣體中揮發性有機物之分析研究

Abstract

本研究之目的是要比較氣喘兒童與非氣喘兒童呼出氣體中揮發性有機物的差異，並藉由問卷與統計將所定性的物種與居家環境因子作連結，探討其中的相關性。 研究設計為橫斷研究法，採立意取樣，以台灣北部某醫學中心小兒氣喘科、眼科及兒童視力保健科門診的病童為研究對象，總共收得60名兒童，年齡範圍介於4到12歲間，分為氣喘兒童30名，非氣喘兒童30名。以自填式問卷方式收集資料，包括基本人口學資料、生活習慣、居家環境、氣喘狀況等，並當場採集兒童之呼出氣體及現場環境空氣，之後再利用氣相層析質譜儀分析呼出氣體及現場環境空氣中揮發性有機物，並採用半定量方式來定量。 在所偵測到的揮發性有機物中定性其中64個物種，種類包括直鏈及支鏈碳氫化合物、酮類及醇類、呋喃類、芳香族、硫化物、含氯化合物、含氮化合物及其他類等；實驗結果使用SPSS13.0軟體進行統計分析，發現有12種化合物的肺泡氣體含量濃度梯度在兩組間的比較達統計上的顯著差異（P＜0.05）；將這些達顯著差異之化合物的肺泡氣體含量濃度梯度與問卷題目進行複迴歸分析，其中10種化合物分別與兒童上學交通方式、家長抽菸、家中是否從事家庭手工、寵物有無、裝潢狀況、家中煮飯頻率、芳香劑使用頻率、蚊香使用頻率、灰塵多寡等生活或環境因子達統計上的顯著差異（P＜0.05）。 研究結果顯示氣喘兒童會呼出2-methyl-1,3-pentadiene、butanenitrile、1-methyl-1H-pyrrole及3-hexanone，但對照兒童並不會呼出；另外isoprene、1-(methylthio)-propane在兩組皆為內生性且氣喘組大於對照組，這些化合物或許可用來當作氣喘的指標。

The objective of this study was to clarify the differences of volatile organic compounds (VOCs) in exhaled air between the asthmatic children and the non-asthmatic children. This article also discusses the correlation between the VOCs and several different indoor environments with questionnaire and statistics. This was a cross-sectional study and purposive selection was taken. All cases came from the out-patient departments of pediatrics and ophthalmology of a medical center in northern Taiwan. There were 60 children total and the range of age was from 4 to 12 years old. 30 of them were asthmatic and others were non-asthmatic. Basic demographic data, life styles, indoor environments and the conditions of asthma were all collected by questionnaire. The exhaled air and the indoor air collected at the out-patient departments of pediatrics and ophthalmology were analyzed by GC/MS and semiquantitative analyses were also done. We focused on 64 kinds of VOCs, such as hydrocarbon, ketone, aldehyde, alcohol, furan, aromatics, sulfur compounds, chlorinate species, nitrogen containing species, etc. The results of the experiment were analyzed by statistical software SPSS13.0. 12 kinds of VOCs showed significant differences in alveolar gradients between the two groups (P＜0.05). 10 out of these 12 kinds of VOCs showed significant differences (P＜0.05) with regard to the means of transport to school, parents smoke, family handiwork, pets, upholsteries, dust, the frequency of cooking, aromatic and mosquito coil incense usage by multiple regression. This research has demonstrated that asthmatic children exhaled 2-methyl-1,3-pentadiene, butanenitrile, 1-methyl-1H-pyrrole and 3-hexanone, but the children in the control group didn’t. Isoprene and 1-(methylthio)-propane are endogenous compounds (proved by positive AG value) and were exhaled in both groups. The AG values of isoprene and 1-(methylthio)-propane were greater in the asthmatic group than in the control group. These compounds may be the candidates for markers of asthma.