临床哮喘控制评估工具和呼出气一氧化氮（FeNO）测定之间的差异
2008/09/28
背景：哮喘是一种炎症性疾病，但是临床上评估哮喘控制的工具不能测定炎症的情况。
目的：确定FeNO与5个哮喘控制评估工具之间的关系。包括ACQ，ACT，NAEPP的治疗目标，JTFPP获得最佳哮喘控制的标准，以及GINA的标准。
方法：6岁以上的哮喘患者由专科医生进行临床评估。所有患者均通过ACT和ACQ以及肺通气和FeNO的测定。内科医生进行哮喘控制评估时并不知道FeNO的测定值。对比分析FeNO的测定值与每一个临床评估工具的结果。
结果：入选了100例6～86岁的哮喘患者，发现FeNO的水平与ACQ (P >0 .99), ACT (P = 0.53), NAEPP (P =0 .53), JTFPP (P =0 .30), 和 GINA (P = 0.86)的评估标准之间没有明显的差异。其敏感度高于NAEPP、JTFPP、和GINA的判断标准，与ACQ 和ACT的判断相当，低于ACQ 或ACT与其它3个评估工具的联合。
结论：除了临床评估以外，结合FeNO的测定，能够更好的找到最佳的治疗方案，指导调整抗炎药物的剂量，明确长期疾病的结果。
（苏楠 卫生部中日友好医院呼吸内科 100029 摘译）
（Ann Allergy Asthma Immunol. 2008 Aug;101(2):124-129）
Discrepancy between clinical asthma control assessment tools and fractional exhaled nitric oxide.
Ann Allergy Asthma Immunol. 2008 Aug;101(2):124-9.
Khalili B, Boggs PB, Shi R, Bahna SL.
Allergy and Immunology Section, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71130, USA.
BACKGROUND: Asthma is an inflammatory disease, yet clinical tools that evaluate asthma control do not include measures of inflammation.
OBJECTIVE: To determine the correlation between fractional exhaled nitric oxide (FeNO) and each of 5 asthma control evaluation tools, namely, the Asthma Control Questionnaire (ACQ), the Asthma Control Test (ACT), the National Asthma Education and Prevention Program (NAEPP) goals of therapy, the Joint Task Force Practice Parameter (JTFPP) on attaining optimal asthma control, and the Global Initiative for Asthma (GINA) guidelines.
METHODS: Patients 6 years or older who had asthma were clinically evaluated by an asthma specialist. Patients completed the ACT and ACQ and underwent spirometry and FeNO measurement. The physician was blinded to FeNO results until asthma control assessments were concluded. Correlations between FeNO level and each clinical evaluation tool were calculated. RESULTS: One hundred patients 6 to 86 years old were enrolled. No significant association was found between FeNO level and asthma control based on ACQ (P > .99), ACT (P = .53), NAEPP (P = .53), JTFPP (P = .30), or GINA (P = .86) criteria. Agreement was high among the NAEPP, the JTFPP, and GINA; moderate between the ACQ and the ACT; and poor to fair between the ACT or the ACQ and the other 3 tools.
CONCLUSIONS: In addition to clinical evaluation, the incorporation of FeNO measurement in evaluating asthma is likely to lead to a more optimal pharmacotherapy, guidance in adjusting the dosage of anti-inflammatory agents, and positive long-term disease outcome.
OBJECTIVE: To determine the correlation between fractional exhaled nitric oxide (FeNO) and each of 5 asthma control evaluation tools, namely, the Asthma Control Questionnaire (ACQ), the Asthma Control Test (ACT), the National Asthma Education and Prevention Program (NAEPP) goals of therapy, the Joint Task Force Practice Parameter (JTFPP) on attaining optimal asthma control, and the Global Initiative for Asthma (GINA) guidelines.
METHODS: Patients 6 years or older who had asthma were clinically evaluated by an asthma specialist. Patients completed the ACT and ACQ and underwent spirometry and FeNO measurement. The physician was blinded to FeNO results until asthma control assessments were concluded. Correlations between FeNO level and each clinical evaluation tool were calculated. RESULTS: One hundred patients 6 to 86 years old were enrolled. No significant association was found between FeNO level and asthma control based on ACQ (P > .99), ACT (P = .53), NAEPP (P = .53), JTFPP (P = .30), or GINA (P = .86) criteria. Agreement was high among the NAEPP, the JTFPP, and GINA; moderate between the ACQ and the ACT; and poor to fair between the ACT or the ACQ and the other 3 tools.
CONCLUSIONS: In addition to clinical evaluation, the incorporation of FeNO measurement in evaluating asthma is likely to lead to a more optimal pharmacotherapy, guidance in adjusting the dosage of anti-inflammatory agents, and positive long-term disease outcome.
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哮鸣音自动检测装置对气道阻塞患者及健康对照受试者的有效性验证
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哮喘孕妇的峰流速值监测
