哮喘联盟

   摘要
   背景：一氧化氮可以在多个流速进行测量，用以确定近端（最大气道一氧化氮通量; JawNO）和远端炎症（肺泡一氧化氮浓度;CANO）。研究旨在观察使用和未使用吸入糖皮质激素治疗的哮喘儿童的症状、肺功能、近端（最大气道一氧化氮通量）和远端（肺泡一氧化氮浓度）气道炎症之间的关系。
   方法：一项带有前瞻性数据的横断面研究，在年龄6～16岁的男性和女性儿童哮喘患者的连续采样中完成。根据二室模型计算最大气道一氧化氮通量和肺泡一氧化氮浓度。哮喘患者完成哮喘控制问卷（CAN）并检测他们的肺功能。观察对照组不同性别之间肺泡一氧化氮及最大气道一氧化氮通量的差异及其与身高的相关性。检测NO50毫升/秒流速的呼出气NO分压（FENO50）、CANO、JawNO、1秒用力呼气容积（FEV1）和CAN问卷之间的相关性，使用卡方检验观察哮喘控制评估的一致性。
   结果：研究纳入162例儿童；49例健康儿童（第1组），23例哮喘但未治疗患者（第2组），80例使用吸入糖皮质激素治疗哮喘患者（第3组）。CANO（ppb）分别为2.2（0.1-4.5），3（0.2-9.2）和2.45（0.1-24）。JawNO（pl/s）分别为516（98.3-1470），2356.67（120-6110）和1426（156-11805）。FENO50与JawNO具有很强的相关性（r =0.97），第2组一致性程度非常好，第3组一致性程度良好。用来监测哮喘控制的措施（FEV1、CAN问卷调查、CANO、和JawNO）之间无或只有轻微的一致性。
   结论：对照组CANO和JawNO结果与那些在其他报告中发现的类似。三个用来评估哮喘控制的测量仪器之间无或只有轻微的一致性。在本研究中，CANO和JawNO未提供额外的信息。
 

（苏楠 审校）
BMC Pulm Med. 2014 Aug 4;14(1):126.

 

Alveolar nitric oxide and its role in pediatric asthma control assessment.
 

Sardón O1, Corcuera P, Aldasoro A, Korta J, Mintegui J, Emparanza JI, Pérez-Yarza EG.
 

ABSTRACT
BACKGROUND: Nitric oxide can be measured at multiple flow rates to determine proximal (maximum airway nitric oxide flux; JawNO) and distal inflammation (alveolar nitric oxide concentration; CANO). The main aim was to study the association among symptoms, lung function, proximal (maximum airway nitric oxide flux) and distal (alveolar nitric oxide concentration) airway inflammation in asthmatic children treated and not treated with inhaled glucocorticoids.
METHODS: A cross-sectional study with prospective data collection was carried out in a consecutive sample of girls and boys aged between 6 and 16 years with a medical diagnosis of asthma. Maximum airway nitric oxide flux and alveolar nitric oxide concentration were calculated according to the two-compartment model. In asthmatic patients, the asthma control questionnaire (CAN) was completed and forced spirometry was performed. In controls, differences between the sexes in alveolar nitric oxide concentration and maximum airway nitric oxide flux and their correlation with height were studied. The correlation among the fraction of exhaled NO at 50 ml/s (FENO50), CANO, JawNO, forced expiratory volume in 1 second (FEV1) and the CAN questionnaire was measured and the degree of agreement regarding asthma control assessment was studied using Cohen's kappa.
RESULTS: We studied 162 children; 49 healthy (group 1), 23 asthmatic participants without treatment (group 2) and 80 asthmatic patients treated with inhaled corticosteroids (group 3). CANO (ppb) was 2.2 (0.1-4.5), 3 (0.2-9.2) and 2.45 (0.1-24), respectively. JawNO (pl/s) was 516 (98.3-1470), 2356.67 (120-6110) and 1426 (156-11805), respectively. There was a strong association (r = 0.97) between FENO50 and JawNO and the degree of agreement was very good in group 2 and was good in group 3. There was no agreement or only slight agreement between the measures used to monitor asthma control (FEV1, CAN questionnaire, CANO and JawNO).
CONCLUSIONS: The results for CANO and JawNO in controls were similar to those found in other reports. There was no agreement or only slight agreement among the three measure instruments analyzed to assess asthma control. In our sample, no additional information was provided by CANO and JawNO.
 

BMC Pulm Med. 2014 Aug 4;14(1):126.