新生儿有无低氧性呼吸衰竭时呼气一氧化氮。

Exhaled nitric oxide in neonates with or without hypoxemic respiratory failure.

机构信息

Department of Pediatrics, Children's Hospital of Fudan University, Shanghai 201102, China (Liu LJ, Wu PP, Qian LL, Chen C, Sun B); Department of Neonatology, Hunan Provincial Children's Hospital, Changsha 410007, China (Gao XR).

出版信息

World J Emerg Med. 2011;2(3):195-200. doi: 10.5847/wjem.j.1920-8642.2011.03.007.

DOI:10.5847/wjem.j.1920-8642.2011.03.007

PMID:25215009

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4129703/

Abstract

BACKGROUND

Exhaled nitric oxide (eNO) is one of the airway condensate derived markers, reflecting mainly airway inflammation in asthma and other lung diseases. The changes of eNO levels as pathophysiology of neonatal hypoxemic respiratory failure (HRF) in early postnatal life have not been thoroughly studied. The present study was to establish a method for measuring eNO concentrations in neonates with or without HRF.

METHODS

Twenty-two newborn infants with HRF and 26 non-NRF controls were included within the first 24 hours of postnatal life. Their eNO levels were detected with a rapid-response chemiluminescence analyzer daily during the first week of their postnatal life, and lung mechanics and gas exchange efficiency were monitored at the same time, such as pulse oxygen saturation (SpO2), inspired fraction of oxygen (FiO2) and other parameters.

RESULTS

During the first two days of postnatal life, eNO values of HRF neonates were significantly higher than those of the control neonates (day 1, 7.9±3.2 vs. 5.8±1.8 parts per billion [ppb], P<0.05; day 2, 8.8±3.2 vs. 6.0±2.4 ppb, P<0.05), but there were no significant differences in the following days. With SpO2/FiO2 increasing, difference of eNO values between the HRF and non-HRF neonates became narrowed, but there was still a two-fold difference of eNO/[SpO2/(FiO2×100)] on days 5-7.

CONCLUSION

We established a method for measuring eNO and found difference in neonates with or without HRF, which diminished with prolonged postnatal days, reflecting pathophysiological characteristics of HRF.

摘要

背景

呼出气一氧化氮（eNO）是气道冷凝物衍生标志物之一，主要反映哮喘和其他肺部疾病的气道炎症。新生儿低氧性呼吸衰竭（HRF）在出生后早期的病理生理学变化中，eNO 水平的变化尚未得到深入研究。本研究旨在建立一种测量有或无 HRF 的新生儿 eNO 浓度的方法。

方法

在出生后 24 小时内，共纳入 22 例 HRF 新生儿和 26 例非 HRF 对照组。在他们出生后的第一周内，每天使用快速响应化学发光分析仪检测他们的 eNO 水平，同时监测肺力学和气体交换效率，如脉搏血氧饱和度（SpO2）、吸入氧分数（FiO2）和其他参数。

结果

在出生后的前两天，HRF 新生儿的 eNO 值明显高于对照组新生儿（第 1 天，7.9±3.2 比 5.8±1.8 十亿分之一 [ppb]，P<0.05；第 2 天，8.8±3.2 比 6.0±2.4 ppb，P<0.05），但在随后的几天中没有显著差异。随着 SpO2/FiO2 的增加，HRF 和非 HRF 新生儿之间的 eNO 值差异逐渐缩小，但在第 5-7 天，eNO/[SpO2/(FiO2×100)]仍有两倍的差异。