Pijnenburg M W H, De Jongste J C
Department of Paediatrics/Paediatric Respiratory Medicine, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.
Clin Exp Allergy. 2008 Feb;38(2):246-59. doi: 10.1111/j.1365-2222.2007.02897.x. Epub 2007 Dec 11.
As an 'inflammometer', the fraction of nitric oxide in exhaled air (Fe(NO)) is increasingly used in the management of paediatric asthma. Fe(NO) provides us with valuable, additional information regarding the nature of underlying airway inflammation, and complements lung function testing and measurement of airway hyper-reactivity. This review focuses on clinical applications of Fe(NO) in paediatric asthma. First, Fe(NO) provides us with a practical tool to aid in the diagnosis of asthma and distinguish patients who will benefit from inhaled corticosteroids from those who will not. Second, Fe(NO) is helpful in predicting exacerbations, and predicting successful steroid reduction or withdrawal. In atopic asthmatic children Fe(NO) is beneficial in adjusting steroid doses, discerning those patients who require additional therapy from those whose medication dose could feasibly be reduced. In pre-school children Fe(NO) may be of help in the differential diagnosis of respiratory symptoms, and may potentially allow for better targeting and monitoring of anti-inflammatory treatment.
作为一种“炎症测定仪”，呼出气中一氧化氮分数（Fe(NO)）在小儿哮喘管理中的应用越来越广泛。Fe(NO)为我们提供了有关潜在气道炎症性质的有价值的额外信息，并且补充了肺功能测试和气道高反应性测量。本综述重点关注Fe(NO)在小儿哮喘中的临床应用。首先，Fe(NO)为我们提供了一种实用工具，有助于哮喘的诊断，并区分哪些患者将从吸入性糖皮质激素中获益，哪些患者不会。其次，Fe(NO)有助于预测病情加重，并预测糖皮质激素减量或停药是否成功。在特应性哮喘儿童中，Fe(NO)有助于调整糖皮质激素剂量，区分哪些患者需要额外治疗，哪些患者的药物剂量可以合理减少。在学龄前儿童中，Fe(NO)可能有助于呼吸道症状的鉴别诊断，并可能使抗炎治疗的靶向性和监测更好。
