Rodway G W, Choi J, Hoffman L A, Sethi J M
Center for Sleep and Respiratory Neurobiology, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania 19104, USA.
Chron Respir Dis. 2009;6(1):19-29. doi: 10.1177/1479972308095936.
Exhaled nitric oxide (eNO) used as an aid to the diagnosis and management of lung disease is receiving attention from pulmonary researchers and clinicians alike because it offers a noninvasive means to directly monitor airway inflammation. Research evidence suggests that eNO levels significantly increase in individuals with asthma before diagnosis, decrease with inhaled corticosteroid administration, and correlate with the number of eosinophils in induced sputum. These observations have been used to support an association between eNO levels and airway inflammation. This review presents an update on current opportunities regarding use of eNO in patient care, and more specifically on its potential usage for asthma diagnosis and monitoring. The review will also discuss factors that may complicate use of eNO as a diagnostic tool, including changes in disease severity, symptom response, and technical measurement issues. Regardless of the rapid, convenient, and noninvasive nature of this test, additional well-designed, long-term longitudinal studies are necessary to fully evaluate the clinical utility of eNO in asthma management.
呼出一氧化氮（eNO）作为辅助诊断和管理肺部疾病的手段，正受到肺部研究人员和临床医生的关注，因为它提供了一种直接监测气道炎症的非侵入性方法。研究证据表明，哮喘患者在诊断前呼出一氧化氮水平显著升高，吸入皮质类固醇后水平降低，且与诱导痰中嗜酸性粒细胞数量相关。这些观察结果被用于支持呼出一氧化氮水平与气道炎症之间的关联。本综述介绍了目前在患者护理中使用呼出一氧化氮的最新机会，更具体地说，是其在哮喘诊断和监测中的潜在用途。该综述还将讨论可能使呼出一氧化氮作为诊断工具的使用复杂化的因素，包括疾病严重程度的变化、症状反应和技术测量问题。尽管该测试具有快速、便捷和非侵入性的特点，但仍需要更多设计良好的长期纵向研究来全面评估呼出一氧化氮在哮喘管理中的临床效用。
