哮喘联盟

   摘要
   背景：哮喘以慢性气道炎症，复杂的连锁反应，大多数会有持续的嗜酸性粒细胞聚集和活化为特征。呼出气一氧化氮测定（FENO）是与支气管嗜酸性粒细胞密切相关的气道炎症的替代标志物。FENO常用来定义哮喘表型，评估嗜酸性粒细胞炎症的严重程度和预测皮质类固醇激素的敏感性。
   目的：本研究的目的是探讨真实世界中的哮喘患者，FeNO是否与某些临床或功能性因素相关。
   方法：在全球范围内连续评估了363名哮喘患者（150名男性，平均年龄46.3岁）。评估参数如下：病史，包括合并症，体检，身体质量指数（BMI），肺功能，哮喘控制分级，哮喘控制测试（ACT）和FeNO。
   结果：以下患者FeNO值显著升高：哮喘控制不良患者（P <0.01）、具有哮喘症状患者（p=0.015）、气喘患者（P <0.001）、诊断为鼻炎患者（p=0.049）、具有鼻炎症状患者（p=0.019），但患有GERD的患者和有肺炎史的患者FeNO值显著降低（分别为p=0.024，p=0.048）。使用最低剂量的皮质类固醇的患者FeNO值升高（p=0.031）。FeNO值> 25 ppb与哮喘控制不良（OR3.71）、哮喘征象（OR 3.5）和症状（OR1.79）相关。FeNO值以29.9ppb为界值，可准确预测（AUC0.7）哮喘控制不良。
   结论：临床实践中FeNO水平评估是一个非常有用的监测哮喘的工具，因为它与几个临床因素相关，包括哮喘控制。
 

（杨冬 审校）
AllergolImmunopathol(Madr). 2015Nov14.pii:S0301-0546(15)00123-8.doi:10.1016/j.aller.2015.05.012. [Epub ahead of print]

 

Exhaled nitric oxide in relation to asthma control: A real-life survey.
 

Ricciardolo FL1, Sorbello V1, Bellezza Fontana R1, Schiavetti I2, Ciprandi G3.
 

Abstract
BACKGROUND:Asthma is characterised by chronic airway inflammation, a complex cascade of events, mostly sustained by eosinophil recruitment and activation. Fractional exhaled nitric oxide (FeNO) is a surrogate marker of airway inflammation closely associated with bronchial eosinophilia. FeNO is used to define asthma phenotype, to assess eosinophilic inflammatory severity and to predict corticosteroid responsiveness.
OBJECTIVE:The aim of this study was to investigate whether FeNO may be associated with some clinical and functional factors in asthmatics evaluated in a real life setting.
METHODS:Globally 363 patients (150 males, mean age 46.3 years) with asthma were consecutively evaluated. The following parameters were assessed: history, including comorbidities, physical examination, body mass index (BMI), lung function, asthma control grade, asthma control test (ACT), and FeNO.
RESULTS:FeNO values were significantly higher in patients with poorly controlled asthma (p<0.01), asthma symptoms (p=0.015), wheezing (p<0.001), rhinitis diagnosis, (p=0.049) and rhinitis symptoms (p=0.019), but lower in patients with GERD (p=0.024) and pneumonia history (p=0.048). FeNO values increased in patients with the lowest corticosteroid dose (p=0.031). FeNO values>25ppb were associated with poorly controlled asthma (OR 3.71), asthma signs (OR 3.5) and symptoms (OR 1.79). A FeNO value cut-off of 29.9ppb was fairly predictive of (AUC 0.7) poorly controlled asthma.
CONCLUSIONS:FeNO assessment in clinical practice may be a useful tool for monitoring asthmatics as it is associated with several clinical factors, including asthma control.
 

AllergolImmunopathol(Madr). 2015Nov14.pii:S0301-0546(15)00123-8.doi:10.1016/j.aller.2015.05.012. [Epub ahead of print]