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Respir Med. 2010 Jul;104(7):945-50. doi: 10.1016/j.rmed.2010.02.003. Epub 2010 Feb 26.
Exhaled NO (FE(NO)) is a steroid dose dependent eosinophilic inflammometer, but also a mediator of bronchomotor tone, but statistically significant relationships have infrequently been obtained with pulmonary function tests (PFT). The aim was to test the hypothesis that the relationships between FE(NO) and PFT could be uncovered by inhaled corticosteroid (ICS) treatment, namely that a link between FE(NO) and bronchodilator response (an index of bronchomotor tone) would appear under ICS.
Exhaled NO, forced expiratory flows and lung volumes were measured in atopic asthmatic children without recent (one month) respiratory symptoms.
Two hundred and thirty children (mean + or - SD, age: 11.2 + or - 2.5 years, 69 girls) were included (% predicted, FEV(1): 100 + or - 14; FEF(50%): 76 + or - 23; RV: 107 + or - 29). The relationship between ICS dose (GINA classification) and FE(NO) plateaued in children with an ICS dose higher than 200 microg beclomethasone equipotent daily dose: FE(NO) (median [25th-75th percentiles]), 43 ppb [15-105] (no treatment, n=65), 33 ppb [15-77] (low dose, n=70), 23 ppb [12-57] (medium dose, n=57) and 26 ppb [9-49] (high dose, n=38). Statistically significant relationships between FE(NO) and PFT were only observed in children receiving more than 200 microg/day ICS: with FEV(1) (medium ICS dose: rho=0.43, p=0.001; high dose: rho=0.32, p=0.052) and bronchodilator (400 microg salbutamol) response (medium dose: rho=0.54, p=0.001; high dose: rho=0.65, p=0.002).
A positive correlation between FE(NO) and bronchomotor tone appears with increasing ICS doses in atopic children with clinically controlled asthma, which further suggests that children depicting the highest FE(NO) values may have lesser steroid sensitivity.
呼出气一氧化氮（FE（NO））是一种类固醇剂量依赖性嗜酸性粒细胞炎症标志物，但也是支气管舒缩性的介质，但与肺功能测试（PFT）之间的统计学关系很少得到证实。目的是检验以下假设，即通过吸入皮质类固醇（ICS）治疗可以揭示 FE（NO）与 PFT 之间的关系，即 FE（NO）与支气管扩张剂反应（支气管舒缩性的指标）之间的联系将在 ICS 下出现。
在没有近期（一个月）呼吸道症状的特应性哮喘儿童中测量呼出气一氧化氮、用力呼气流量和肺容积。
共纳入 230 名儿童（平均+或-标准差，年龄：11.2+或-2.5 岁，69 名女孩）（预计百分比，FEV（1）：100+或-14；FEF（50%）：76+或-23；RV：107+或-29）。ICS 剂量（GINA 分类）与 FE（NO）之间的关系在 ICS 剂量高于 200μg 倍氯米松等效日剂量的儿童中趋于平稳：FE（NO）（中位数[25%-75%]），43 ppb [15-105]（无治疗，n=65），33 ppb [15-77]（低剂量，n=70），23 ppb [12-57]（中剂量，n=57）和 26 ppb [9-49]（高剂量，n=38）。仅在接受超过 200μg/天 ICS 的儿童中观察到 FE（NO）与 PFT 之间存在统计学显著关系：与 FEV（1）（中剂量 ICS 剂量：rho=0.43，p=0.001；高剂量：rho=0.32，p=0.052）和支气管扩张剂（400μg 沙丁胺醇）反应（中剂量：rho=0.54，p=0.001；高剂量：rho=0.65，p=0.002）。
在临床控制的哮喘特应性儿童中，随着 ICS 剂量的增加，FE（NO）与支气管舒缩性之间出现正相关，这进一步表明，FE（NO）值最高的儿童可能对类固醇的敏感性较低。
