Malerba Mario, Radaeli Alessandro, Ragnoli Beatrice, Airo' Paolo, Corradi Massimo, Ponticiello Antonio, Zambruni Alberto, Grassi Vittorio
Department of Internal Medicine, University of Brescia, 1 Divisione di Medicina Interna, Spedali Civili, Pzza Spedali Civili 1, 25100 Brescia, Italy.
Chest. 2007 Aug;132(2):575-80. doi: 10.1378/chest.06-2929. Epub 2007 Jun 5.
Systemic sclerosis (SSc) is a connective tissue disorder of unknown etiology that is often complicated by pulmonary involvement, with pulmonary hypertension (PH) and interstitial lung disease (ILD) being the major causes of death. It has been suggested that the amount of nitric oxide (NO) in exhaled air may predict the onset of complications. The aim of the study was to measure exhaled NO in SSc patients and investigate its relationship with pulmonary involvement with and without PH.
Fifty patients (5 men and 45 women; mean age, 59.1 +/- 11.7 years [+/- SD]) with a diagnosis of SSc based on the preliminary criteria of the American Rheumatism Association, and 40 healthy control subjects (5 men and 35 women; mean age, 58.3 +/- 12.2 years) underwent exhaled NO measurements by means of a chemiluminescence analyzer, pulmonary function tests, high-resolution thorax CT, and Doppler echocardiography.
Exhaled NO concentrations were significantly higher in SSc patients than control subjects (p = 0.02), and significantly lower in the patients with ILD and/or PH than in those without PH (p < 0.01). There was a significant inverse correlation between pulmonary artery systolic pressure and exhaled NO concentration in all of the studied patients (r = - 0.5, p < 0.001).
Our results indicate that exhaled air NO concentrations are lower in SSc patients with lung involvement than in those without, and that SSc patients without ILD or PH have higher exhaled NO values than healthy subjects.
系统性硬化症（SSc）是一种病因不明的结缔组织疾病，常并发肺部受累，肺动脉高压（PH）和间质性肺疾病（ILD）是主要死因。有研究表明，呼出气体中一氧化氮（NO）的含量可能预测并发症的发生。本研究旨在测量SSc患者呼出的NO，并探讨其与有无PH的肺部受累之间的关系。
50例患者（5例男性和45例女性；平均年龄59.1±11.7岁[±标准差]）根据美国风湿病协会的初步标准诊断为SSc，40例健康对照者（5例男性和35例女性；平均年龄58.3±12.2岁）通过化学发光分析仪进行呼出NO测量、肺功能测试、高分辨率胸部CT和多普勒超声心动图检查。
SSc患者呼出的NO浓度显著高于对照组（p = 0.02），ILD和/或PH患者呼出的NO浓度显著低于无PH患者（p < 0.01）。在所有研究患者中，肺动脉收缩压与呼出NO浓度之间存在显著负相关（r = - 0.5，p < 0.001）。
我们的结果表明，有肺部受累的SSc患者呼出气体中的NO浓度低于无肺部受累者，且无ILD或PH的SSc患者呼出的NO值高于健康受试者。
