哮喘联盟

   摘要
   简介：慢性咳嗽通常指持续8周或更长的时间的咳嗽，其病因有时是不明确的。在患者评估中呼出一氧化氮（FeNO）已作为一项测定指标。尚无研究评估测量呼出NO对于诊断慢性咳嗽的价值。因此，我们的目的是研究测量呼出NO和鼻腔NO是否能作为慢性咳嗽的初步评估指标。
   方法：我们研究了52位持续超过8周长期咳嗽的不吸烟患者，已经诊断出咳嗽病因。在不同的恒定呼气流量下进行多个单次呼吸的NO分析，以评估鼻腔NO和FeNO水平。通过在不同呼气流量下测得的NO浓度，推出组织和支气管腔气象之间NO的总流量（J'aw NO），以及肺泡的NO浓度（Cano）。
   结果：患者被分为四类：咳嗽变异性哮喘（CVA），非哮喘嗜酸细胞性支气管炎（NAEB），上气道咳嗽综合征（UACS）和胃食管反流病（GERD）。对比UACS和GERD，CVA和NAEB的呼出NO和J'awNO均较高；Cano和鼻腔NO水平在四组间未见明显差异。
   结论：我们的研究表明，FeNO水平测量有助于慢性咳嗽的病因诊断。此外，我们没有发现在多个呼吸流量下测定呼出NO水平和鼻腔NO水平有其他的价值。

 

（苏欣 审校）
Respir Med. 2015 May 22. pii: S0954-6111(15)00186-9. doi: 10.1016/j.rmed.2015.05.016. [Epub ahead of print]

 

Extended analysis of exhaled and nasal nitric oxide for the evaluation of chroniccough.
 

Maniscalco M1, Faraone S2, Sofia M3, Molino A3, Vatrella A4, Zedda A2.
Author information
 

Abstract
INTRODUCTION:Chronic cough is usually defined as a cough that lasts for eight weeks or longer. Its etiological diagnosis is not always straightforward, and the measurement of exhaled nitric oxide (FeNO) has been proposed in patients' evaluation. No studies have assessed the usefulness of extended exhaled NO measurement for the evaluation of chronic cough. Therefore, we aimed at evaluating the usefulness of an extended exhaled NO measurement and nasal NO for an initial evaluation of chronic cough.
METHODS:We studied 52 non-smoker patients with prolonged cough lasting more than eight weeks. Etiologies of cough were identified. Nasal NO and FeNO were assessed using multiple single-breath NO analysis at different constant expiratory flow-rates. From the fractional NO concentration measured at each flow-rate, the total NO flux between tissue and gas phase in the bronchial lumen (J'awNO), and the alveolar NO concentration (Cano) were extrapolated.
RESULTS:The patients were classified in four categories: cough variant asthma (CVA), nonasthmatic eosinophilic bronchitis (NAEB), upper airway cough syndrome (UACS) and gastro-esophageal reflux disease (GERD). Compared with UACS and GERD, both exhaled NO and J'awNO were higher in CVA and NAEB, and no differences were found in Cano and nasal NO level among the four groups.
CONCLUSIONS:Our study suggests a potentially useful role for FeNO measurement in the etiological diagnosis of chronic cough. We did not find any additive value of performing exhaled NO at multiple flow-rates and nasal NO measurements.
 

Respir Med. 2015 May 22. pii: S0954-6111(15)00186-9. doi: 10.1016/j.rmed.2015.05.016. [Epub ahead of print]