哮喘联盟

   摘要
   前言：在运动员中，运动导致的呼吸道症状很常见，关于这些症状的评估耗时耗力。
   目的：本文旨在评价呼出气NO浓度（FENO）对气道高反应性（BHR）及哮喘的预测作用。
   材料与方法：有哮喘提示症状的87名运动员与87名久坐患者(对照组)接受FENO和BHR检测，BHR检测通过乙酰甲胆碱激发试验（MCH）和碳酸呼吸增强法（EVH）（运动员组）或组胺激发试验（HIST）（对照组）完成。
   结果：在运动员组， FENO升高(>30 ppb)与经肺功能确诊的哮喘或MCH阳性无关，但受试者特性（ROC）分析提示一些对EVH阳性的预测价值[曲线下面积（AUC）0.625，95%可信区间(CI)：0.53-0.78，P=0.020]。但其灵敏度（55%）和特异性（71%）均较差。在久坐患者中，FENO值与经肺功能确诊的哮喘或HIST阳性显著相关，ROC分析显示FENO值能显著预测HIST阳性（AUC 0.83,95%CI:0.70-0.96，P=0.001）和哮喘（AUC 0.74,95%CI:0.63-0.85，P<0.001）。
   结论：研究结果表明，与久坐患者相反，FENO值不能预测运动员BHR和临床哮喘。对于具有运动性呼吸道症状的运动员来说，FENO值不是一个有效的筛查指标。
 

(林江涛 审校)
pr 7. doi: 10.1111/crj.12014. [Epub ahead of print]

 

Exhaled nitric oxide indicates poorly athlete's asthma.
 

Voutilainen M, Malmberg LP, Vasankari T, Haahtela T.
 

Abstract
INTRODUCTION: In athletes, exercise-induced respiratory symptoms are common and their assessment is time and resource consuming.
OBJECTIVE: The objective was to evaluate fractional concentration of exhaled nitric oxide (FENO) as a predictor of bronchial hyperresponsiveness (BHR) and of asthma.
MATERIALS AND METHODS: Eighty-seven elite athletes and a control group of 87 sedentary patients with symptoms suggesting asthma underwent measurements of FENO and of BHR by using methacholine provocation test (MCH) and eucapnic voluntary hyperpnoea (EVH) (athletes) or histamine provocation test (HIST) (controls).
RESULTS: In athletes, elevated FENO (>30 ppb) was not associated with lung function-confirmed asthma or with MCH positivity, but receiver operating characteristics (ROC) analysis showed some predictive value for EVH positivity [Area Under Curve (AUC) 0.652, 95% confidence interval (CI): 0.53 to 0.78, P = 0.020]. However, the sensitivity (55%) and the specificity (71%) were poor. In sedentary patients, FENO was significantly associated with both confirmed asthma and HIST positivity, ROC analysis showing FENO to be significantly predictive for HIST positivity (AUC 0.83, 95% CI: 0.70 to 0.96, P = 0.001) and for asthma (AUC 0.74, 95% CI: 0.63 to 0.85, P < 0.001).
CONCLUSION: The results suggest that in contrast to sedentary patients, FENO seems to be a poor predictor of BHR and of clinical asthma in elite athletes. We find it unlikely that FENO could be a useful screening tool in athletes with exercise-induced respiratory symptoms.
 

pr 7. doi: 10.1111/crj.12014. [Epub ahead of print