哮喘联盟

   摘要
   简介：测量哮喘儿童呼出气一氧化氮（FeNO）的临床意义尚不清楚。目的：旨在评估哮喘儿童呼出气一氧化氮水平与支气管扩张剂使用前和使用后第1秒用力呼气量（FEV1）变化的关系。
   方法：该研究为一项回顾性、横断面研究。我们评估的数据来源于儿童哮喘患者的医学病例，特别是那些关注FeNO值、哮喘严重度、FEV1（预测值的百分比）和支气管可逆性试验（BRT）的数据。
   结果：405例受试者（年龄6～18岁）完成该项研究。FeNO中值水平随受试者的年龄增长呈线性增加（P=0.025）。我们发现间歇性哮喘和轻度哮喘患者在支气管扩张剂使用前，FEV1与FeNO四分位水平呈非线性趋势。我们还发现FeNo更高的患儿在支气管扩张剂使用前FEV1更低，但这仅出现在FeNO值在35.4 ppb以内时；当患儿FeNO值高于35.4 ppb时，支气管扩张剂使用前的FEV1增加。在中度哮喘患儿中，FEV1 相对于 FeNO自基线（400 mcg 沙丁胺醇后）的变化呈线性增长趋势。
   结论：研究结果提示，在使用呼吸量测定法之前和之后均需测量FeNO。因此，我们也建议哮喘儿童伴支气管阻塞者在使用短效β2受体激动剂后测量FeNO。
 

（苏楠 审校）
Respir Care. 2013 Dec 31. [Epub ahead of print]


 

The interpretation of exhaled nitric oxide values in children with asthma depends on the degree of bronchoconstriction and the levels of asthma severity.
 

Tomasz G, Pawel M, Joanna J, Wlodzimierz S, Rafal S, Anna J, Aleksandra G, Konrad W, Eusebio MO, Iwona S.
 

Abstract
INTRODUCTION: The clinical implications of FeNO measurements in childhood asthma are unclear. AIM:: We aimed to evaluate the relationship between the level of exhaled nitric oxide and pre-bronchodilator FEV1 and the change in FEV1 after bronchodilator in children with asthma.
METHODS:It was a retrospective, cross-sectional study. We evaluated data from medical documentation of children with asthma with special attention to FeNO results, asthma severity, FEV1 (% predicted), and bronchial reversibility test (BRT).
RESULTS:Four hundred and five subjects (aged 6-18) completed the study. Median levels of FeNO increased linearly with subjects' age (p=0.025). We found a non-linear trend of pre-bronchodilator FEV1 across four quartiles of FeNO in episodic and mild asthma; we observed lower pre-bronchodilator FEV1 in children with higher FeNO, but only up to the FeNO value of 35.4 ppb; in children with FeNO value higher than 35.4 ppb, pre-bronchodilator FEV1 was increased. We found a linear increasing trend of change from baseline (after 400 mcg of salbutamol) in FEV1 across FeNO categories in children with moderate asthma.
CONCLUSIONS:Our results suggest a need to measure FeNO before as well as after spirometry. Consequently, in children with asthma with bronchial obstruction we suggest assessing FeNO also after short-acting Beta2-agonists.
 

Respir Care. 2013 Dec 31. [Epub ahead of print]