Department of Pediatrics, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden.
Pediatr Pulmonol. 2010 Mar;45(3):241-8. doi: 10.1002/ppul.21137.
Fraction of exhaled nitric oxide (FENO) is often reduced in cystic fibrosis (CF). FENO at different expiratory flows can provide an indication of the site of nitric oxide production. The aim of this study was to examine whether NO parameters are related to overall (FEV(1)) or peripheral (lung clearance index, LCI, measured by multiple breath SF(6) washout) airway function and systemic inflammation in CF. Secondary aim was to compare alveolar NO and bronchial NO flux calculated by two different mathematical models, a linear and a nonlinear method. Thirty-five healthy and 45 CF children were recruited. FENO at 50 ml/sec (FENO(50)) and bronchial NO flux were lower in CF than controls, 9.5 (2.7-38.8) (median (range)) versus 12.4 (5.2-40.1) ppb, P = 0.029, and 391 (97-1772) versus 578 (123-1993) (pl/sec), P = 0.036, respectively. No difference in alveolar NO was shown. The nonlinear method resulted in lower alveolar NO and higher bronchial flux, than the linear method, but the result was closely correlated in both groups. LCI was higher in CF than controls, 8.4 (6.5-12.9) versus 5.9 (5.1-7.8), P < 0.001. FENO(50) was negatively correlated with LCI (r = -0.43; P = 0.003) and positively correlated with FEV(1) (r = 0.42, P = 0.004) in CF. Alveolar NO correlated negatively with inflammatory markers: orosomucoid (r = -0.42, P = 0.005), platelets (r = -0.50, P < 0.001) and white blood cell count (r = -0.48, P = 0.001). In conclusion, FENO(50) and bronchial NO flux are reduced in young CF subjects and low FENO(50) is associated with overall and small airway obstruction. NO parameters derived from the different models were closely related but the values differed slightly.
呼出气一氧化氮（FENO）分数在囊性纤维化（CF）中经常降低。不同呼气流量的 FENO 可以提供一氧化氮产生部位的指示。本研究的目的是检查 NO 参数是否与 CF 中的整体（FEV1）或外周（通过多次呼吸 SF6 清除测量的肺清除指数，LCI）气道功能和全身炎症相关。次要目的是比较通过两种不同的数学模型（线性和非线性方法）计算的肺泡 NO 和支气管 NO 通量。招募了 35 名健康儿童和 45 名 CF 儿童。CF 儿童的 FENO（50）（FEV1）和支气管 NO 通量低于对照组，分别为 9.5（2.7-38.8）（中位数（范围））和 12.4（5.2-40.1）ppb，P=0.029，和 391（97-1772）和 578（123-1993）（pl/sec），P=0.036。未显示肺泡 NO 存在差异。与线性方法相比，非线性方法导致肺泡 NO 降低和支气管通量升高，但两种方法的结果在两组中均密切相关。LCI 在 CF 中高于对照组，分别为 8.4（6.5-12.9）和 5.9（5.1-7.8），P<0.001。FENO（50）与 LCI 呈负相关（r=-0.43；P=0.003），与 CF 中的 FEV1 呈正相关（r=0.42，P=0.004）。肺泡 NO 与炎症标志物：粘蛋白（r=-0.42，P=0.005）、血小板（r=-0.50，P<0.001）和白细胞计数（r=-0.48，P=0.001）呈负相关。总之，年轻 CF 患者的 FENO（50）和支气管 NO 通量降低，低 FENO（50）与整体和小气道阻塞相关。两种模型衍生的 NO 参数密切相关，但值略有不同。
