呼出氣一氧化氮檢測在支氣管哮喘中的應用_《華西醫學》

作者：

成都市第三人民醫院呼吸科（成都，610031）;

關鍵詞：

呼出氣一氧化氮支氣管哮喘診斷評價嚴重程度指導用藥

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【摘要】呼出氣一氧化氮（FeNO）作為一項無創、便捷的監測技術，能夠測定氣道炎癥，特別對于重癥哮喘不能行肺功能檢測的患者，具有較高的臨床可行性。其在支氣管哮喘的診斷、評價嚴重程度、控制水平、指導用藥和預測預后等方面有獨特的臨床價值，特別是FeNO在診斷支氣管哮喘有較高的敏感性和特異性己基本達成共識，但各個研究設定的閾值不盡相同，還需要進一步研究；在評價哮喘的嚴重程度及控制水平方面價值是有限的；對指導用藥的價值是臨床爭論最多的領域；預測（哮喘發作）預后，FeNO升高對預測哮喘患者病情發展均有所幫助，可使患者得到早期預防、治療。但如何利用其更好的管理和監測哮喘還有待進一步探討。

引用本文： 王曉霞,蘇嫻,包勇. 呼出氣一氧化氮檢測在支氣管哮喘中的應用. 華西醫學, 2010, 25(9): 1765-1768. doi: 復制

1.	任旭斌, 劉春濤, 黃玉芬, 等. 呼出氣一氧化氮檢測對支氣管哮喘的診斷價值[J]. 中國呼吸與危重監護雜志, 2009, 8(4): 322-326.
2.	王雯, 王辰. 支氣管哮喘患者呼出氣一氧化氮監測的臨床意義. 中國醫刊, 2007, 42(12): 145.
3.	Turner S. Exhaled nitric oxide in the diagnosis and management of asthma[J]. Curr Opin Allergy Clin Immunol, 2008, 8(1): 70-76.
4.	Olivieri M, Talamini G, Corradi M, et al. Reference values for exhaled nitric oxide(reveno) study[J]. Respir Res, 2006, 7(1): 94.
5.	Silkoff PE, Erzurum SC, Lundberg JO, et al. ATS workshop proceedings: exhaled nitric oxide oxidative metabolism in exhaled breath condensate[J]. proc Am Thorac Soc, 2006, 3(2): 131-145.
6.	Schneider A, Tilemann L, Schermer T, et al. Diagnosing asthma in general practice with portable exhaled nitric oxide measurement[J]. Respir Res, 2009, 10(1): 15.
7.	Sivan Y, Gadish T, Fireman E, et al. The use of exhaled nitric oxide in the diagnosis of asthma in school children[J]. J Pediatr, 2009, 155(2): 211-216.
8.	Smith AD, Cowan JO, Filsell S, et al. Diagnosing asthma: comparisons between exhaled nitric oxide measurements and conventional tests[J]. Am J Respir Crit Care Med, 2004, 169(4): 473-478.
9.	梁斌苗, 王茂筠, 王佑娟. 呼出氣一氧化氮對哮喘診斷價值的系統評價[J]. 中國呼吸與危重監護雜志, 2009, 8(2): 135-130.
10.	Delgado-Corcoran C, Kissoon N, Murphy SP, et al. Exhaled nitric oxide reflects asthma severity and asthma control[J]. Pediatr Crit Care Med, 2004, 5(1): 48-52.
11.	Kwok MY, Walsh-Kelly CM, Gorelick MH. The role of exhaled nitric oxide in evaluation of acute asthma in a pediatric emergency department[J]. Acad Emerg Med, 2009, 16(1): 21-28.
12.	鄭永華, 陸晶晶, 張麗萍. 支氣管哮喘與NO濃度的檢測研究及臨床意義[J]. 臨床肺科雜志, 2009, 14 (3): 327-328.
13.	Timothy J, Vivienne Mairs, Patrick S, et al. Exhaled nitric oxide in relation to the clinical features of childhood asthma[J]. J Asthma, 2004, 41(7): 751-757.
14.	Khalili B, Boggs PB, Shi R, et al. Discrepancy between clinical asthma control assessment tools and fractional exhaled nitric oxide[J]. Ann Allergy Asthma Immunol, 2008, 101(2): 124-129.
15.	Isozaki A, Kawano Y, Shoda T, et al. The comparison of Japanese pediatric asthma control test (JPAC) with the childhood asthma control test (C-ACT) based on respiratory function and fractional exhaled nitric oxide[J]. Arerugi, 2009, 58(6): 648-656.
16.	Smith AD, Cowan JO, Brassett KP, et al. Use of exhaled nitric oxide measurements to guide treatment in chronic asthma[J]. N Engl J Med, 2005, 352(21): 2163-2173.
17.	Hewitt RS, Modrich CM, Cowan JO, et al. Outcomes using exhaleel nitric oaicle measwre ments as an aeljunct to primary care asthma managencent[J]. Prim Care Respir J, 2009, 18(4): 320-327.
18.	De Jongste JC, Carraro S, Hop WC, et al. Daily telemonitoring of exhaled nitric oxide and symptoms in the treatment of childhood asthma[J]. Am J Respir Crit Care Med, 2009, 179(2): 93-97.
19.	Szefler SJ, Mitchell H, Sorkness CA, et al. Management of asthma based on exhaled nitric oxide in addition to guideline-based treatment for inner-city adolescents and young adults: a randomised controlled trial[J]. Lancet, 2008, 372(9643): 1065-1072.
20.	Petsky KL, Cates CJ, Li AM, et al. Tailored interventions based on exhaled nitric oxide versus clinical symptoms for asthma in children and adults[J]. Cochrane Database Syst Rev, 2008, 2: CD006340.
21.	Pijnenburg MW, Hofhuis W, Hop WC, et al. Exhaled nitric oxide predicts asthma relapse in children with clinical asthma remission[J]. Thorax, 2005, 60(3): 215-218.
22.	Mahut B, Delclaux C. Why should we measure exhaled NO in asthma patients[J]. Rev Mal Respir, 2006, 23(4 Pt 2): 1041-1043.
23.	Cabral AL, Vollmer WM, Barbirotto RM, et al. Exhaled nitric oxide as a predictor of exacerbation in children with moderate-to-severe asthma: a prospective, 5-month study[J]. Ann Allergy Asthma Immunol, 2009, 103(3): 206-211.
24.	Taylor DR. Exhaled NO: forward, backward, or sideways[J]? Am J Respir Cric Care Med, 2007, 176(3): 221-222.
25.	Taylor DR. Exhaled nitric oxide: still alive, not laid to rest[J]. Am J Respir Cric Care Med, 2009, 179(2): 88-89.

1. 任旭斌, 劉春濤, 黃玉芬, 等. 呼出氣一氧化氮檢測對支氣管哮喘的診斷價值[J]. 中國呼吸與危重監護雜志, 2009, 8(4): 322-326.
2. 王雯, 王辰. 支氣管哮喘患者呼出氣一氧化氮監測的臨床意義. 中國醫刊, 2007, 42(12): 145.
3. Turner S. Exhaled nitric oxide in the diagnosis and management of asthma[J]. Curr Opin Allergy Clin Immunol, 2008, 8(1): 70-76.
4. Olivieri M, Talamini G, Corradi M, et al. Reference values for exhaled nitric oxide(reveno) study[J]. Respir Res, 2006, 7(1): 94.
5. Silkoff PE, Erzurum SC, Lundberg JO, et al. ATS workshop proceedings: exhaled nitric oxide oxidative metabolism in exhaled breath condensate[J]. proc Am Thorac Soc, 2006, 3(2): 131-145.
6. Schneider A, Tilemann L, Schermer T, et al. Diagnosing asthma in general practice with portable exhaled nitric oxide measurement[J]. Respir Res, 2009, 10(1): 15.
7. Sivan Y, Gadish T, Fireman E, et al. The use of exhaled nitric oxide in the diagnosis of asthma in school children[J]. J Pediatr, 2009, 155(2): 211-216.
8. Smith AD, Cowan JO, Filsell S, et al. Diagnosing asthma: comparisons between exhaled nitric oxide measurements and conventional tests[J]. Am J Respir Crit Care Med, 2004, 169(4): 473-478.
9. 梁斌苗, 王茂筠, 王佑娟. 呼出氣一氧化氮對哮喘診斷價值的系統評價[J]. 中國呼吸與危重監護雜志, 2009, 8(2): 135-130.
10. Delgado-Corcoran C, Kissoon N, Murphy SP, et al. Exhaled nitric oxide reflects asthma severity and asthma control[J]. Pediatr Crit Care Med, 2004, 5(1): 48-52.
11. Kwok MY, Walsh-Kelly CM, Gorelick MH. The role of exhaled nitric oxide in evaluation of acute asthma in a pediatric emergency department[J]. Acad Emerg Med, 2009, 16(1): 21-28.
12. 鄭永華, 陸晶晶, 張麗萍. 支氣管哮喘與NO濃度的檢測研究及臨床意義[J]. 臨床肺科雜志, 2009, 14 (3): 327-328.
13. Timothy J, Vivienne Mairs, Patrick S, et al. Exhaled nitric oxide in relation to the clinical features of childhood asthma[J]. J Asthma, 2004, 41(7): 751-757.
14. Khalili B, Boggs PB, Shi R, et al. Discrepancy between clinical asthma control assessment tools and fractional exhaled nitric oxide[J]. Ann Allergy Asthma Immunol, 2008, 101(2): 124-129.
15. Isozaki A, Kawano Y, Shoda T, et al. The comparison of Japanese pediatric asthma control test (JPAC) with the childhood asthma control test (C-ACT) based on respiratory function and fractional exhaled nitric oxide[J]. Arerugi, 2009, 58(6): 648-656.
16. Smith AD, Cowan JO, Brassett KP, et al. Use of exhaled nitric oxide measurements to guide treatment in chronic asthma[J]. N Engl J Med, 2005, 352(21): 2163-2173.
17. Hewitt RS, Modrich CM, Cowan JO, et al. Outcomes using exhaleel nitric oaicle measwre ments as an aeljunct to primary care asthma managencent[J]. Prim Care Respir J, 2009, 18(4): 320-327.
18. De Jongste JC, Carraro S, Hop WC, et al. Daily telemonitoring of exhaled nitric oxide and symptoms in the treatment of childhood asthma[J]. Am J Respir Crit Care Med, 2009, 179(2): 93-97.
19. Szefler SJ, Mitchell H, Sorkness CA, et al. Management of asthma based on exhaled nitric oxide in addition to guideline-based treatment for inner-city adolescents and young adults: a randomised controlled trial[J]. Lancet, 2008, 372(9643): 1065-1072.
20. Petsky KL, Cates CJ, Li AM, et al. Tailored interventions based on exhaled nitric oxide versus clinical symptoms for asthma in children and adults[J]. Cochrane Database Syst Rev, 2008, 2: CD006340.
21. Pijnenburg MW, Hofhuis W, Hop WC, et al. Exhaled nitric oxide predicts asthma relapse in children with clinical asthma remission[J]. Thorax, 2005, 60(3): 215-218.
22. Mahut B, Delclaux C. Why should we measure exhaled NO in asthma patients[J]. Rev Mal Respir, 2006, 23(4 Pt 2): 1041-1043.
23. Cabral AL, Vollmer WM, Barbirotto RM, et al. Exhaled nitric oxide as a predictor of exacerbation in children with moderate-to-severe asthma: a prospective, 5-month study[J]. Ann Allergy Asthma Immunol, 2009, 103(3): 206-211.
24. Taylor DR. Exhaled NO: forward, backward, or sideways[J]? Am J Respir Cric Care Med, 2007, 176(3): 221-222.
25. Taylor DR. Exhaled nitric oxide: still alive, not laid to rest[J]. Am J Respir Cric Care Med, 2009, 179(2): 88-89.

《華西醫學》

呼出氣一氧化氮檢測在支氣管哮喘中的應用

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《華西醫學》

呼出氣一氧化氮檢測在支氣管哮喘中的應用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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