Silkoff P E, Wakita S, Chatkin J, Ansarin K, Gutierrez C, Caramori M, McClean P, Slutsky A S, Zamel N, Chapman K R
Division of Respiratory Medicine, Faculty of Medicine, University of Toronto, Canada.
Am J Respir Crit Care Med. 1999 Mar;159(3):940-4. doi: 10.1164/ajrccm.159.3.9805044.
Exhaled nitric oxide (ENO) is used increasingly as a surrogate marker of airway inflammation in research protocols that may incorporate standard efficacy measures, such as spirometry before and after bronchodilator, which could affect ENO measurements. In seven healthy volunteers and 11 mild asthmatic subjects, we measured ENO before and serially for 1 h after spirometry. On two additional days in the subjects with asthma, we reexamined the effect of spirometry as before, followed by the serial measurement of ENO for 1 h after two puffs of salbutamol (100 microgram/puff) by metered-dose inhaler or matching placebo. As early as 1 min after spirometry, ENO fell by 13% and 10% in the normal and asthmatic subjects, respectively. In both groups, ENO returned to baseline over 1 h. In the asthmatic subjects, salbutamol caused a significant mean increase of the order of 10 parts per billion in ENO (p < 0.001) for 1 h as compared with placebo inhaler. We conclude that spirometry and beta2-agonist may perturb ENO values and recommend that studies control for these factors.
呼出一氧化氮（ENO）在研究方案中越来越多地用作气道炎症的替代标志物，这些研究方案可能纳入标准疗效测量方法，如支气管扩张剂前后的肺功能测定，而这可能会影响ENO测量值。在7名健康志愿者和11名轻度哮喘患者中，我们在肺功能测定前后测量了ENO，并在测定后连续1小时进行测量。在哮喘患者的另外两天里，我们像之前一样重新检查了肺功能测定的影响，然后通过定量吸入器吸入两喷沙丁胺醇（100微克/喷）或匹配的安慰剂后，连续1小时测量ENO。早在肺功能测定后1分钟，正常受试者和哮喘患者的ENO分别下降了13%和10%。在两组中，ENO在1小时内恢复到基线水平。在哮喘患者中，与安慰剂吸入器相比，沙丁胺醇使ENO在1小时内平均显著增加约十亿分之十（p<0.001）。我们得出结论，肺功能测定和β2激动剂可能会干扰ENO值，并建议研究中控制这些因素。
