哮喘联盟

摘要
   背景与目的：呼出气一氧化氮分数（FeNO）增加能反映哮喘患者的气道炎症。中央气道NO流量（J'awNO; nl/s）和外周气道/肺泡NO浓度（CANO；ppb）能分别进行计算。CANO 能反映小气道炎症。本试验研究CANO水平与稳定哮喘患者的临床和生理学指标的相关性。
   方法：73名哮喘控制较好的患者入选本研究，平均年龄为61岁。检测50, 100, 150和200 ml/s时的FeNO，并进行肺功能检测。计算J'awNO(TMAD)和CANO(TMAD) ，并采用喇叭形气道树和轴向扩散(TMAD)进行校正。
   结果：CANO(TMAD)与FEF(25-75)、EF(25-75) %预测值、FEF(50,) 、FEF(50) %预测值显著相关(分别为R = -0.39 p = 0.002, R = -0.29 p = 0.02, R = -0.39 p = 0.001, R = -0.29 p = 0.02)CANO(TMAD) 与年龄正相关(R = -0.45 p = 0.0002)，与哮喘病程相关性较弱(R = -0.27 p = 0.03). FEV(1) /FVC与 CANO(TMAD)、J'awNO(TMAD)和50ml/s时的FeNO成负相关。在这些指标中，FEV1/FVC与50ml/s时的FeNO的相关性最强(R = -0.34 p = 0.004).
   结论：对于稳定期哮喘患者，CANO(TMAD)可能是一个比FeNO和J'awNO(TMAD)更有特异性的外周气道梗阻标志物。

                                                                                            (刘国梁 审校)
                                Respirology. 2012 Dec 13. doi: 10.1111/resp.12031. [Epub ahead of print]


Alveolar nitric oxide concentration reflects peripheral airway obstruction in stable asthma.

Fujisawa T, Yasui H, Akamatsu T, Hashimoto D, Enomoto N, Inui N, Nakamura Y, Maekawa M, Suda T, Chida K.

Source
Department of Laboratory Medicine, Hamamatsu University School of Medicine, Hamamatsu, JAPAN; Internal Medicine 2 (Divisions of Endocrinology & Metabolism, Respiratology & Hepatology), Hamamatsu University School of Medicine, Hamamatsu, JAPAN.

Abstract
BACKGROUND AND OBJECTIVE: Increased fraction of exhaled nitric oxide (FeNO) has been shown to reflect airway inflammation in asthma. Central airway NO flux (J'awNO; nl/s) and peripheral airway/alveolar NO concentration (CANO; ppb) can be calculated separately. CANO has been reported to reflect small airway inflammation. The aim of the present study is to correlate CANO levels with clinical and physiological parameters in patients with stable asthma.
METHODS: Seventy-three well-controlled asthmatics (mean age 61) were enrolled. Measurement of FeNO (at 50, 100, 150, and 200 ml/s) and pulmonary function test were performed. J'awNO(TMAD) and CANO(TMAD) were calculated and corrected by the trumpet shape of the airway tree and axial back-diffusion (TMAD).
RESULTS: CANO(TMAD) was significantly correlated with FEF(25-75) , FEF(25-75) %pred, FEF(50,) FEF(50) %pred (R = -0.39 p = 0.002, R = -0.29 p = 0.02, R = -0.39 p = 0.001, R = -0.29 p = 0.02, respectively). CANO(TMAD) was positively correlated with age (R = -0.45 p = 0.0002), and weakly correlated with duration of asthma (R = -0.27 p = 0.03). FEV(1) /FVC was negatively correlated with CANO(TMAD) , J'awNO(TMAD) and FeNO 50ml/s. Among these, correlation between FEV1/FVC and FeNO 50ml/s was the strongest (R = -0.34 p = 0.004).
CONCLUSIONS: CANO(TMAD) may be a more specific marker of peripheral airway obstruction than FeNO and J'awNO(TMAD) in stable asthma.

Respirology. 2012 Dec 13. doi: 10.1111/resp.12031. [Epub ahead of print]