呼出气一氧化氮用于研究理发师工作性相关咳嗽
2011/05/12
摘要
背景：职业和环境因素可能是导致非哮喘性嗜酸性粒细胞性支气管炎(NAEB)的原因。职业性NAEB的诊断需要痰液嗜酸性粒细胞的相关证据。然而，一小部分患者无法获得合适的痰液样本。
方法：本病例报道一名25岁的女性理发师，自20岁开始从事该行业，并接触过硫酸铵，到本科室进行工作相关性鼻炎和咳嗽检查。
结果：吸入过硫酸铵能诱发患者的干咳，但第1秒呼气体积(FEV1)无显著变化。在吸入刺激前后均未能有效获得痰液诱导。在吸入刺激后，呼出气一氧化氮分数(FeNO)显著增加，能够诊断为由过硫酸铵导致的职业性NAEB。
结论：基于本病例，我们认为可以将FeNO检测纳入到工作相关性咳嗽中的特异性过敏原刺激诊断中；当痰液收集行不通或不成功时，可以作为诱导痰液检查的一个替代工具，来评价支气管炎症。
（陈欣 审校）
Am J Ind Med. 2011 Mar 10. doi: 10.1002/ajim.20948. [Epub ahead of print]
The use of fractional exhaled nitric oxide in investigation of work-related cough in a hairdresser.
Pala G, Pignatti P, Moscato G.
Allergy and Immunology Unit, Fondazione ’Salvatore Maugeri’, Institute of Care and Research, Scientific Institute of Pavia, Pavia, Italy. giannipalass@libero.it.
Abstract
BACKGROUND: Occupational and environmental factors may be a cause of nonasthmatic eosinophilic bronchitis (NAEB). The diagnosis of occupational NAEB requires evidence of sputum eosinophilia. Nevertheless, a minority of patients are not able to produce suitable sputum specimens.
METHODS: This case report describes a 25-year-old woman, working as a hairdresser since the age of 20 years and handling ammonium persulfate, who came under our observation for work-related rhinitis and cough.
RESULTS: A specific inhalation challenge with ammonium persulfate elicited dry cough, without any significant change in forced expiratory volume in 1 s (FEV(1) ). Sputum induction was unsuccessful both pre- and after specific inhalation challenge. Fractional exhaled nitric oxide (FeNO) values significantly increased after specific inhalation challenge, suggesting a diagnosis of occupational NAEB due to ammonium persulfate.
CONCLUSIONS: From this observation we suggest that FeNO measurement should be added to the investigation of work-related cough during specific inhalation challenge, and may be considered as an alternative to induced sputum to evaluate bronchial inflammation when sputum collection is unavailable or unsuccessful.
Am J Ind Med. 2011 Mar 10. doi: 10.1002/ajim.20948. [Epub ahead of print]
背景：职业和环境因素可能是导致非哮喘性嗜酸性粒细胞性支气管炎(NAEB)的原因。职业性NAEB的诊断需要痰液嗜酸性粒细胞的相关证据。然而，一小部分患者无法获得合适的痰液样本。
方法：本病例报道一名25岁的女性理发师，自20岁开始从事该行业，并接触过硫酸铵，到本科室进行工作相关性鼻炎和咳嗽检查。
结果：吸入过硫酸铵能诱发患者的干咳，但第1秒呼气体积(FEV1)无显著变化。在吸入刺激前后均未能有效获得痰液诱导。在吸入刺激后，呼出气一氧化氮分数(FeNO)显著增加，能够诊断为由过硫酸铵导致的职业性NAEB。
结论：基于本病例，我们认为可以将FeNO检测纳入到工作相关性咳嗽中的特异性过敏原刺激诊断中；当痰液收集行不通或不成功时，可以作为诱导痰液检查的一个替代工具，来评价支气管炎症。
（陈欣 审校）
Am J Ind Med. 2011 Mar 10. doi: 10.1002/ajim.20948. [Epub ahead of print]
The use of fractional exhaled nitric oxide in investigation of work-related cough in a hairdresser.
Pala G, Pignatti P, Moscato G.
Allergy and Immunology Unit, Fondazione ’Salvatore Maugeri’, Institute of Care and Research, Scientific Institute of Pavia, Pavia, Italy. giannipalass@libero.it.
Abstract
BACKGROUND: Occupational and environmental factors may be a cause of nonasthmatic eosinophilic bronchitis (NAEB). The diagnosis of occupational NAEB requires evidence of sputum eosinophilia. Nevertheless, a minority of patients are not able to produce suitable sputum specimens.
METHODS: This case report describes a 25-year-old woman, working as a hairdresser since the age of 20 years and handling ammonium persulfate, who came under our observation for work-related rhinitis and cough.
RESULTS: A specific inhalation challenge with ammonium persulfate elicited dry cough, without any significant change in forced expiratory volume in 1 s (FEV(1) ). Sputum induction was unsuccessful both pre- and after specific inhalation challenge. Fractional exhaled nitric oxide (FeNO) values significantly increased after specific inhalation challenge, suggesting a diagnosis of occupational NAEB due to ammonium persulfate.
CONCLUSIONS: From this observation we suggest that FeNO measurement should be added to the investigation of work-related cough during specific inhalation challenge, and may be considered as an alternative to induced sputum to evaluate bronchial inflammation when sputum collection is unavailable or unsuccessful.
Am J Ind Med. 2011 Mar 10. doi: 10.1002/ajim.20948. [Epub ahead of print]
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