哮喘联盟

   摘要
   介绍：慢性咳嗽通常定义为持续8周或以上的咳嗽。慢性咳嗽的病因学诊断通常都不是直接的，并且呼出气一氧化氮检测(FeNO)已经被建议用于患者的评估。但是并没有相关研究将呼出气NO检测用于慢性咳嗽的评估。因此我们旨在了解呼出气NO检测以及鼻腔NO检测用于慢性咳嗽初始评估的作用。
   方法：我们研究了52例持续咳嗽超过8周的非吸烟患者。对咳嗽已进行病因诊断。采用多重单呼吸NO分析不同恒定呼气流速水平下的鼻腔NO和FeNO水平。从每一次呼气流速测量到的分次NO浓度来看，总的NO流量介于支气管腔的组织与气相之间(J'awNO)，并且可以由此推断出肺泡NO的浓度(Cano)。
   结果：这些患者可以被分为四个类型：咳嗽变异型哮喘(CVA)、非支气管哮喘嗜酸粒细胞性支气管炎(NAEB)、上呼吸道咳嗽综合征(UACS)以及胃食管反流病(GERD)。与UACS和GERD相比，CVA和NAEB患者的呼气NO以及J'awNO均较高，并且这四组患者的 Cano和鼻腔NO水平并无差异。
   结论：我们的研究认为FeNO检测在慢性咳嗽的病因诊断中可以起到潜在的有利作用。我们并未发现对多重气流进行呼气NO以及鼻腔NO测量的额外价值。
 

（苏欣 审校）
Respir Med. 2015 Aug;109(8):970-4. doi: 10.1016/j.rmed.2015.05.016. Epub 2015 May 22.


 

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

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

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 Aug;109(8):970-4. doi: 10.1016/j.rmed.2015.05.016. Epub 2015 May 22.