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呼出一氧化氮分数在哮喘控制中的临床作用。

The clinical role of fractional exhaled nitric oxide in asthma control.

作者信息

Sato Suguru, Saito Junpei, Fukuhara Atsuro, Uematsu Manabu, Suzuki Yasuhito, Togawa Ryuichi, Sato Yuki, Nikaido Takefumi, Wang Xintao, Tanino Yoshinori, Munakata Mitsuru

机构信息

Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima City, Japan.

Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima City, Japan.

出版信息

Ann Allergy Asthma Immunol. 2017 Dec;119(6):541-547. doi: 10.1016/j.anai.2017.09.059. Epub 2017 Oct 27.

Abstract

BACKGROUND

The potential role and characteristics of fractional exhaled nitric oxide (FeNO) remain unclear in the treatment of asthma.

OBJECTIVE

To explore the clinical role of FeNO in asthmatic treatment.

METHODS

We evaluated whether the mean or change of FeNO levels in the treatment period is associated with other conventional control parameters and predicted some clinical outcomes of asthma. We retrospectively analyzed the mean and percentage change of FeNO levels in the first 5 measurements at our hospital.

RESULTS

The study found a significantly strong correlation between FeNO level at diagnosis and the largest changes of FeNO values from diagnosis. No significant correlations were observed between FeNO levels and other parameters (Asthma Control Test [ACT] score or forced expiratory volume in one second [FEV]) in mean and percentage change of values under treatment of asthma; however, significant positive correlations were found between ACT scores and FEV. The mean FeNO level revealed a significant negative correlation with an annual change in FEV in individuals with asthma who were followed up for more than 2 years. Both the mean ACT score and percent predicted FEV revealed a significant negative correlation with occasional use of systemic corticosteroids.

CONCLUSION

During conventional treatment of asthma, the largest changes of FeNO values from diagnosis were strongly correlated with FeNO levels at diagnosis. As for the unlikely conventional parameters, no significant associations were observed between FeNO levels and deterioration of asthma during the treatment periods. An elevated mean FeNO level may be a marker of decreased lung function in individuals with asthma.

摘要

背景

呼出气一氧化氮分数(FeNO)在哮喘治疗中的潜在作用和特征仍不明确。

目的

探讨FeNO在哮喘治疗中的临床作用。

方法

我们评估了治疗期间FeNO水平的均值或变化是否与其他传统控制参数相关,并预测哮喘的一些临床结局。我们回顾性分析了我院前5次测量中FeNO水平的均值和百分比变化。

结果

研究发现诊断时的FeNO水平与诊断后FeNO值的最大变化之间存在显著的强相关性。在哮喘治疗期间,FeNO水平与其他参数(哮喘控制测试[ACT]评分或一秒用力呼气量[FEV])的均值和百分比变化之间未观察到显著相关性;然而,ACT评分与FEV之间存在显著的正相关性。在随访超过2年的哮喘患者中,FeNO平均水平与FEV的年度变化呈显著负相关。ACT平均评分和预测FEV百分比均与偶尔使用全身糖皮质激素呈显著负相关。

结论

在哮喘的常规治疗期间,诊断后FeNO值的最大变化与诊断时的FeNO水平密切相关。至于不太可能的传统参数,在治疗期间FeNO水平与哮喘恶化之间未观察到显著关联。FeNO平均水平升高可能是哮喘患者肺功能下降的一个标志。

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