Division of Respirology, Department of Medicine, The Ottawa Hospital, ON, Canada.
Expert Rev Respir Med. 2012 Feb;6(1):105-15. doi: 10.1586/ers.12.1.
The ability to assess the inflammatory status of a patient's airway using a noninvasive method is the ideal situation for clinicians. Owing in part to the relationship between the levels of exhaled nitric oxide to inflammation and the ease of the technique, the measurement of the fraction of exhaled nitric oxide (F(E)NO) has achieved considerable attention, particularly with respect to asthma. A multitude of studies have shown that when measured in exhaled air, this unique molecule has the potential to have both diagnostic and therapeutic roles in the clinical setting for many pulmonary diseases. The incorporation of F(E)NO into asthma management and treatment algorithms may help shed further insight on the current control and future risk of patients. Research is ongoing to determine the biology and the benefits of the use of F(E)NO in respiratory conditions in addition to asthma. This review will briefly outline the pathophysiology of nitric oxide, the measurement of F(E)NO and the potential clinical uses of F(E)NO in asthma and a number of other respiratory diseases. Despite its promise, until further research is conducted, the use of F(E)NO cannot be recommended for routine clinical management of respiratory diseases at present, but should be considered as an adjuvant to help guide therapy in certain patients with asthma and in those with eosinophilic bronchitis.
临床医生理想的情况是能够使用非侵入性方法评估患者气道的炎症状态。部分由于呼出气一氧化氮（FeNO）与炎症之间的关系水平以及该技术的易用性，FeNO 分数（F（E）NO）的测量已引起了相当大的关注，特别是在哮喘方面。大量研究表明，当在呼出气中测量时，这种独特的分子在许多肺部疾病的临床环境中具有潜在的诊断和治疗作用。将 F（E）NO 纳入哮喘管理和治疗算法中可能有助于进一步深入了解患者的当前控制和未来风险。目前正在进行研究，以确定 F（E）NO 在除哮喘以外的呼吸疾病中的生物学和使用益处。这篇综述将简要概述一氧化氮的病理生理学、F（E）NO 的测量以及 F（E）NO 在哮喘和其他一些呼吸系统疾病中的潜在临床应用。尽管有希望，但在进一步研究之前，目前不能推荐将 F（E）NO 用于常规临床管理呼吸系统疾病，但应将其视为辅助手段，以帮助指导某些哮喘患者和嗜酸性支气管炎患者的治疗。
