Exhaled nitric oxide predicts persistence of wheezing, exacerbations, and decline in lung function in wheezy infants and toddlers.
Exhaled nitric oxide predicts persistence of wheezing, exacerbations, and decline in lung function in wheezy infants and toddlers.
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DOI：
10.1111/cea.12171
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发表时间：
2013-12
期刊：
影响因子：
--
通讯作者：
Debley JS
中科院分区：
文献类型：
--
作者：
Elliott M;Heltshe SL;Stamey DC;Cochrane ES;Redding GJ;Debley JS
评估呼出气一氧化氮分数（FENO）对反复喘息的婴儿/幼儿持续喘息、病情加重或肺功能随时间变化的预测价值的数据有限。在一项正在进行的反复喘息婴幼儿纵向队列研究中，比较单次呼吸FENO（SB-FENO）、潮式呼吸混合呼气FENO（tidal-FENO）、支气管扩张剂反应性（BDR）和Castro-Rodriquez哮喘预测指数（API），用于喘息持续性、急性加重、和肺功能的变化，通过年龄3岁。入组用力呼气流量和容量（iPFT）进行了测量，在44名婴儿/幼儿使用提高容量快速胸腹按压法。SB-FENO以50 mL/sec测量，并且在清醒潮式呼吸期间测量潮式-FENO。在42名婴儿中，在3岁时评估了临床结局。32名受试者在2.5-3岁之间完成了随访iPFT。入组时SB-FENO浓度≥30 ppb可预测3岁时喘息持续性，灵敏度为77%，特异性为94%，曲线下面积（AUC）为0.86（95% CI：0.74 - 0.98）。SB-FENO对喘息持续性和加重的敏感性、特异性、阳性预测值和阴性预测值上级潮汐-FENO、BDR和API。入组时测量的SB-FENO ≥30 ppb和潮气FENO ≥7 ppb与入组至3岁之间FEV0.5和FEF 25 -75下降相关。在喘息的婴儿/幼儿中，SB-FENO在预测3岁时喘息的未来加重和持续性方面上级潮汐-FENO、BDR和API。SB-FENO和潮气FENO均与肺功能随时间下降相关。
There are limited data assessing the predictive value of fraction of exhaled nitric oxide (FENO) for persistence of wheezing, exacerbations, or lung function change over time in infants/toddlers with recurrent wheezing. In an ongoing longitudinal cohort of infants and toddlers with recurrent wheezing compare predictive values of single-breath FENO (SB-FENO), tidal-breathing mixed-expired FENO (tidal-FENO), bronchodilator responsiveness (BDR), and the Castro-Rodriquez asthma predictive index (API) for persistence of wheezing, exacerbations, and lung function change through age 3 yrs. Enrollment forced expiratory flows and volumes (iPFTs) were measured in 44 infants/toddlers using the raised-volume rapid thoracoabdominal compression method. SB-FENO was measured at 50 mL/sec, and tidal-FENO was measured during awake tidal breathing. Clinical outcomes were assessed at age 3 yrs. in 42 infants. Follow-up iPFTs were completed between ages 2.5-3 yrs. in 32 subjects. An enrollment SB-FENO concentration ≥30 ppb predicted persistence of wheezing at age 3 years with a sensitivity of 77%, a specificity of 94%, and an area under the curve (AUC) of 0.86 (95% CI: 0.74 – 0.98). The sensitivity, specificity, positive predictive, and negative predictive values of SB-FENO for persistence of wheezing and exacerbations were superior to tidal-FENO, BDR, and the API. SB-FENO ≥30 ppb and tidal FENO ≥7 ppb measured at enrollment was associated with a decline in both FEV0.5 and FEF25-75 between enrollment and age 3 years. In wheezy infants/toddlers SB-FENO was superior to tidal-FENO, BDR, and the API in predicting future exacerbations and persistence of wheezing at age 3 years. Both SB-FENO and tidal FENO were associated with lung function decline over time.
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影响因子：
10
作者：
Borrego, L. M.;Stocks, J.;Hoo, F.
通讯作者：
Hoo, F.
影响因子：
158.5
作者：
Ducharme, Francine M.;Lemire, Chantal;Platt, Robert W.
通讯作者：
Platt, Robert W.
影响因子：
24.3
作者：
Franklin, PJ;Turner, SW;Stick, SM
通讯作者：
Stick, SM
影响因子：
24.3
作者：
Gabriele, C.;Jaddoe, V. W.;de Jongste, J. C.
通讯作者：
de Jongste, J. C.
DOI：
10.1164/rccm.200406-710st
发表时间：
2005-04-15
影响因子：
24.7
作者：
American Thoracic Society;European Respiratory Society
通讯作者：
European Respiratory Society