Pijnenburg Mariëlle W, Floor Suzanne E, Hop Wim C, De Jongste Johan C
Department of Pediatric Respiratory Medicine, Erasmus MC-Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Pediatr Allergy Immunol. 2006 May;17(3):189-93. doi: 10.1111/j.1399-3038.2006.00394.x.
Exhaled NO (FENO) is a non-invasive, validated marker for asthmatic airway inflammation. Recently, a new hand-held NO-analyzer has been developed which makes it possible to monitor FENO at home. We assessed feasibility and analyzed variability of daily FENO home measurements. Twenty-one asthmatics (mean age 14.5 yr; range 8-25 yr) participated. Nineteen used a stable dose of inhaled corticosteroids and all of them were in a stable clinical condition. FENO was measured twice daily for 14 consecutive days. Measurements and symptom scores were recorded on a smart card in the analyzer. Symptom score items included well-being, wheeze, activity, and nocturnal symptoms. Measurements showed a success rate of 93%. We found a significant diurnal variation in FENO with geometric mean morning levels 14% higher than evening levels (95% CI: 4%-25%; p = 0.013). Individual subjects showed marked fluctuation of FENO. The mean intrasubject coefficient of variation of FENO was 40% for morning and 36% for evening values. FENO and cumulative symptom scores did not correlate. Home FENO measurements are feasible, and offer the possibility to asses airway inflammation on a daily basis. Further study is needed to interpret and evaluate possible benefits of FENO home monitoring.
呼出一氧化氮（FENO）是一种用于评估哮喘气道炎症的无创且经过验证的标志物。最近，一种新型手持式一氧化氮分析仪已被研发出来，这使得在家中监测FENO成为可能。我们评估了在家中每日测量FENO的可行性，并分析了其变异性。21名哮喘患者（平均年龄14.5岁；范围8 - 25岁）参与了研究。其中19名患者使用稳定剂量的吸入性糖皮质激素，且所有患者临床状况稳定。连续14天每天测量两次FENO。测量值和症状评分记录在分析仪的智能卡上。症状评分项目包括健康状况、喘息、活动及夜间症状。测量成功率为93%。我们发现FENO存在显著的昼夜变化，几何平均早晨水平比晚上水平高14%（95%置信区间：4% - 25%；p = 0.013）。个体受试者的FENO显示出明显波动。FENO的平均受试者内变异系数早晨为40%，晚上为36%。FENO与累积症状评分无相关性。在家中测量FENO是可行的，并且提供了每日评估气道炎症的可能性。需要进一步研究来解释和评估在家中监测FENO的潜在益处。
