Sezione di Malattie dell'Apparato Respiratorio, Dipartimento di Scienze Mediche e Chirurgiche, Universita' di Foggia, Foggia, Italy.
Dipartimento di Emergenza Urgenza, Spedali Civili di Brescia, Brescia, Italy.
Biomed Res Int. 2018 Aug 26;2018:7292045. doi: 10.1155/2018/7292045. eCollection 2018.
Pulmonary hypertension (PH) is a progressive fatal disease thus, noninvasive prognostic tools are needed to follow these patients. The aim of our study was to evaluate fractional exhaled nitric oxide (FeNO) and exhaled breath temperature (EBT) values in patients with PH from different causes and to correlate them with respiratory functional data.
Twenty-four PH patients underwent spirometry, carbon monoxide diffusion (DLCO) test, transthoracic echocardiography, right-heart catheterization, and FeNO and EBT measurements.
We studied 3 groups according to the type of PH: 10 patients with pulmonary arterial hypertension (PAH) (group A), 11 patients with PH due to chronic obstructive pulmonary disease (COPD) (group B), and 3 patients with PH associated with left heart disease (group C). Mean FeNO values tend to be higher in group B (15.0 ± 9.3ppb) compared with other groups (respectively, 9.9 ± 5.7 and 8.5 ± 5.2 ppb in groups A and C; p = 0.271) but no statistical significance has been reached. Mean values of alveolar NO concentration (CANO) were higher in groups A and B compared to group C (respectively, 16.9 ± 12.6; 13.9 ± 6.8; and 6.7 ± 2.0 ppb) (p = 0.045). EBT mean values were significantly lower in group C when compared with other groups (group C: 29.0 +- 1.3°C, groups A and B: 30.9 ± 1.3 and 31.2 ± 1.2°C, respectively: p = 0.041). EBT levels were inversely correlated to mean pulmonary artery pressure (PAPm) levels (Spearman coefficient -0.481; p = 0.017).
eNO, CANO, and EBT have been evaluated in three groups of PH patients. Interestingly EBT reduction was correlated with PAPm increase, whereas FeNO was higher in COPD patients and CANO in PAH and COPD groups. Further studies are needed to clarify EBT, FeNO, and CANO roles as biomarkers in the monitoring of patients with PH.
肺动脉高压（PH）是一种进行性致命疾病，因此需要非侵入性的预后工具来监测这些患者。我们的研究目的是评估不同病因 PH 患者的呼出气一氧化氮分数（FeNO）和呼气温度（EBT）值，并将其与呼吸功能数据相关联。
24 例 PH 患者行肺量计、一氧化碳弥散（DLCO）试验、经胸超声心动图、右心导管检查及 FeNO 和 EBT 测量。
根据 PH 类型，我们将患者分为 3 组：10 例特发性肺动脉高压（PAH）患者（A 组）、11 例慢性阻塞性肺疾病（COPD）相关 PH 患者（B 组）和 3 例左心疾病相关 PH 患者（C 组）。B 组 FeNO 平均值（15.0±9.3ppb）高于其他组（A 组和 C 组分别为 9.9±5.7 和 8.5±5.2ppb；p=0.271），但无统计学意义。A 组和 B 组肺泡 NO 浓度（CANO）平均值高于 C 组（分别为 16.9±12.6、13.9±6.8 和 6.7±2.0ppb；p=0.045）。C 组 EBT 平均值明显低于其他组（C 组：29.0±1.3°C，A 组和 B 组：30.9±1.3 和 31.2±1.2°C；p=0.041）。EBT 值与平均肺动脉压（PAPm）呈负相关（Spearman 系数 -0.481；p=0.017）。
本研究评估了 3 组 PH 患者的 eNO、CANO 和 EBT。有趣的是，EBT 降低与 PAPm 升高相关，而 COPD 患者的 FeNO 升高，PAH 和 COPD 患者的 CANO 升高。需要进一步的研究来阐明 EBT、FeNO 和 CANO 在 PH 患者监测中的作用。
