Université de Bordeaux, UB2, Centre de Recherche Cardio-Thoracique, CIC 0005, F-33076 Bordeaux, France.
Respir Med. 2011 Jul;105(7):989-96. doi: 10.1016/j.rmed.2011.01.006. Epub 2011 Feb 3.
Fractional exhaled nitric oxide (F(E)NO) is a marker of airway inflammation in asthma. Monitoring of such inflammation is currently not included in asthma guidelines and remains controversial. The hypothesis underlying the present study was that, F(E)NO could help assessing asthma control and, therefore, improve its management, by predicting loss of control in asthmatics.
A total of 90 adult asthmatics were included in the study. Asthma control was evaluated according to ACQ. All patients underwent F(E)NO by chemiluminescent (EndoNO) and hand-held (MINO) devices, followed by lung function testing.
MINO was accurate as compared to EndoNO. F(E)NO was significantly increased in uncontrolled as compared to controlled asthmatics using both devices. F(E)NO measurement was able to predict control maintenance in controlled asthmatics in the absence of any change in their treatment. Indeed, using cut-off values of 31 and 40 ppb, the negative predictive values were 95 and 97% for EndoNO and MINO, respectively. EndoNO and MINO were also able to assess asthma control, although to a lesser extent.
These findings suggest that F(E)NO can predict the persistence of asthma control in controlled patients and may now be used in asthma management since it can accurately be measured by means of hand-held devices.
呼出气一氧化氮分数（F(E)NO）是哮喘气道炎症的标志物。目前，这种炎症的监测并未纳入哮喘指南，且仍存在争议。本研究的假设是，F(E)NO 可以通过预测哮喘患者控制的丧失，从而帮助评估哮喘控制，并改善其管理。
本研究共纳入 90 例成年哮喘患者。根据 ACQ 评估哮喘控制。所有患者均接受化学发光（EndoNO）和手持式（MINO）设备的 F(E)NO 检测，并进行肺功能测试。
MINO 比 EndoNO 更准确。与控制良好的哮喘患者相比，未控制的哮喘患者的 F(E)NO 明显升高。使用两种设备，F(E)NO 测量值能够预测控制良好的哮喘患者在不改变治疗方案的情况下维持控制。实际上，使用 31 和 40 ppb 的截断值，EndoNO 和 MINO 的阴性预测值分别为 95%和 97%。EndoNO 和 MINO 也能够评估哮喘控制，但程度较轻。
这些发现表明，F(E)NO 可以预测控制良好的患者哮喘控制的持续时间，并且由于可以通过手持式设备准确测量，因此现在可以用于哮喘管理。
