Carrà S, Gagliardi L, Zanconato S, Scollo M, Azzolin N, Zacchello F, Baraldi E
Department of Paediatrics, University of Padova, Italy.
Respir Med. 2001 Sep;95(9):734-9. doi: 10.1053/rmed.2001.1130.
Exhaled nitric oxide (ENO) has been proposed as a marker of airway inflammation in asthma and could be useful to evaluate the response to anti-inflammatory treatment. We investigated the effect of budesonide and nedocromil sodium on ENO levels and lung function in asthmatic children. Twenty stable steroid-naïve asthmatic children were randomized in a single blind, cross-over study to receive inhaled budesonide (group A) or nedocromil sodium (group B) for 6 weeks. ENO was measured with a chemiluminescence analyser at baseline and at the end of each treatment period. Repeated-measures ANOVA was carried out. In asthmatic baseline ENO levels [mean 32.5 ppb, 95% confidence interval (CI) 26.4 to 38.7] were significantly higher compared to reference values (8.7 ppb, 95% CI 8.1 to 9.2, P<0.001). There were no treatment-order effect, no carry-over effect and in both groups the response pattern was the same: budesonide significantly lowered ENO levels from 41.0 ppb to 22.8 ppb in group A (mean, P<0.01) and from 22.6 ppb to 13.0 ppb in group B, (mean, P<0.05), while nedocromil did not reduce ENO values (from 24.4 ppb to 22.6 ppb in group B and from 22.8 ppb to 38.0 ppb in group A, mean, P = NS and P<0.01 respectively). After budesonide treatment ENO values of asthmatics were still significantly higher than in healthy children The baseline values of FEV1 and FEF(25-75) were normal in both groups and no significant changes were observed during the study. In conclusion, our study shows that budesonide, but not nedocromil sodium, significantly reduces ENO levels in stable asthmatic children even in absence of changes in the lung function.
呼出一氧化氮（ENO）已被提议作为哮喘气道炎症的标志物，并且可能有助于评估抗炎治疗的反应。我们研究了布地奈德和奈多罗米钠对哮喘儿童ENO水平和肺功能的影响。20名病情稳定且未使用过类固醇的哮喘儿童被纳入一项单盲交叉研究，随机分为两组，分别接受吸入布地奈德（A组）或奈多罗米钠（B组）治疗6周。在基线期和每个治疗期结束时，使用化学发光分析仪测量ENO。进行重复测量方差分析。哮喘儿童的基线ENO水平[平均值32.5 ppb，95%置信区间（CI）26.4至38.7]显著高于参考值（8.7 ppb，95% CI 8.1至9.2，P<0.001）。不存在治疗顺序效应和残留效应，且两组的反应模式相同：布地奈德使A组的ENO水平从41.0 ppb显著降至22.8 ppb（平均值，P<0.01），使B组从22.6 ppb降至13.0 ppb（平均值，P<0.05），而奈多罗米未降低ENO值（B组从24.4 ppb降至22.6 ppb，A组从22.8 ppb升至38.0 ppb，平均值，P分别为无统计学意义和P<0.01）。布地奈德治疗后，哮喘患者的ENO值仍显著高于健康儿童。两组的FEV1和FEF(25 - 75)基线值均正常，研究期间未观察到显著变化。总之，我们的研究表明，布地奈德而非奈多罗米钠能显著降低病情稳定的哮喘儿童的ENO水平，即便肺功能无变化。
