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[一氧化氮测量在呼吸系统疾病中的作用]

[Role of measurement of nitric oxide in respiratory diseases].

作者信息

Pravettoni Valerio, Incorvaia Cristoforo, Frati Franco

出版信息

Recenti Prog Med. 2008 May;99(5):258-62.

Abstract

Nitric oxide (NO) is a molecule with a homeostatic role in a number of physiological processes. Concerning respiratory diseases, exhaled nitric oxide (FE(NO)) is a marker of airway inflammation, and its measurement can be easily performed. To date, a large number of publications defined the performances of FE(NO). Studies on asthma attributed to FE(NO) an important role in diagnosis and especially in monitoring the effects of anti-inflammatory treatment, which label it as an "inflammometer" to be used as a guide in therapy algorithms. Less consistent results were thus far obtained in chronic obstructive lung disease, in which FE(NO) levels seem usually higher than in healthy subjects but lower than in asthma, unless an eosinophil inflammation is present, and in rhinosinusitis, where the levels of nasal NO (nNO) are low, probably because of a reduced NO flow into the nose due to mucosal swelling, while they increase after an effective treatment. Among other respiratory disorders, such as cystic fibrosis and primary ciliary dyskinesia, nNO levels are particularly low in the latter (possibly for the trapping and altered NO metabolism caused by dense secretions, and by decreased NO synthase activity) and suggest nNO as a good screening tool for such disease.

摘要

一氧化氮(NO)是一种在许多生理过程中具有稳态作用的分子。关于呼吸系统疾病,呼出一氧化氮(FE(NO))是气道炎症的标志物,其测量操作简便。迄今为止,大量出版物对FE(NO)的性能进行了定义。关于哮喘的研究表明,FE(NO)在诊断中尤其是在监测抗炎治疗效果方面发挥着重要作用,这使其被视为一种“炎症计”,可用于治疗方案的指导。到目前为止,在慢性阻塞性肺疾病中获得的结果不太一致,在该疾病中,FE(NO)水平通常似乎高于健康受试者,但低于哮喘患者,除非存在嗜酸性粒细胞炎症;而在鼻窦炎中,鼻一氧化氮(nNO)水平较低,这可能是由于黏膜肿胀导致进入鼻腔的一氧化氮流量减少,不过在有效治疗后会升高。在其他呼吸系统疾病中,如囊性纤维化和原发性纤毛运动障碍,后者的nNO水平特别低(可能是由于浓稠分泌物导致一氧化氮被困住以及一氧化氮代谢改变,以及一氧化氮合酶活性降低),这表明nNO是此类疾病的良好筛查工具。

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