Increase in alveolar nitric oxide in the presence of symptoms in childhood asthma
Increase in alveolar nitric oxide in the presence of symptoms in childhood asthma
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DOI：
10.1378/chest.125.3.1012
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发表时间：
2004-03-01
期刊：
影响因子：
9.6
通讯作者：
Delclaux, C
中科院分区：
文献类型：
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作者：
Mahut, B;Delacourt, C;Delclaux, C
研究目的：确定哮喘患儿呼出气一氧化氮（NO）输出量（QNO）中肺泡和近端气道室的各自贡献，并将其变化与轻度症状或支气管阻塞相关联。在15名近期症状轻微的哮喘儿童、30名无症状哮喘儿童和15名健康儿童中，在多个呼气流量（V）速率下测量呼出的NO浓度，允许使用两种方法，即线性和非线性模型，计算肺泡和近端气道在QNO中的贡献。测量结果和结果：无症状和近期有症状的患者在FEV 1和最大V（FVC的25%和75%之间（MEF 25 -15））方面没有显著差异：FEV 1，93.3 +/- 13.4% vs 90 +/- 7.5%; MEF 25 -15，70 +/- 22% vs 68 +/- 28%预测值（平均值+/- SD）。最近有症状的患者与无症状患者（p < 0.0001）以及无症状患者与健康儿童（p < 0.02）的最大气道QNO输出量显着较高：分别为134 +/- 7 nl/min、55 +/- 43 nl/min和19 +/- 8 nl/min。在多元回归分析中，影响气道QNO输出的变量是症状（p < 0.0001）和MEF 25 -75评估的远端气道阻塞（p < 0.05）。肺泡NO浓度（FANo）显著高于对照组（P <0.05）。（p < 0.03）近期有症状的患者比无症状的患者高，而无症状的患者和健康儿童之间无显著差异：分别为7.2 +/- 2.4 ppb，5.5 +/- 2.7 ppb和4.2 +/- 2.0 ppb。在出现症状时观察到FANo增加，哮喘期间近端气道NO输出与远端阻塞相关。
Study objectives: To determine respective contributions of alveolar and proximal airway compartments in exhaled nitric oxide (NO) Output (QNO) in pediatric patients with asthma and to correlate their variations with mild symptoms or bronchial obstruction.Patients and design: In 15 asthmatic children with recent mild symptoms, 30 asymptomatic asthmatic children, and 15 healthy children, exhaled NO concentration was measured at multiple expiratory flow (V) rates allowing the calculation of alveolar and proximal airway contributions in QNO, using two approaches, ie, linear and nonlinear models. Measurements and results:Asymptomatic and recently symptomatic patients were not significantly different regarding FEV1 and maximum V between 25% and 75% of FVC (MEF25-15): FEV1, 93.3 +/- 13.4% vs 90 +/- 7.5%; MEF25-15, 70 +/- 22% vs 68 +/- 28% of predicted values, respectively (mean +/- SD). Maximal airway QNO output was significantly higher in recently symptomatic vs asymptomatic patients (p < 0.0001), and in asymptomatic patients vs healthy children (p < 0.02): 134 +/- 7 nl/min, 55 +/- 43 nl/min, and 19 +/- 8 nl/min, respectively. In a multiple regression analysis, variables that influenced airway QNO output were symptoms (p < 0.0001) and distal airway obstruction as assessed by MEF25-75 (p < 0.05). Alveolar NO concentration (FANo) was significantly (p < 0.03) higher in recently symptomatic than in patients without symptoms, whereas it was not significantly different between asymptomatic patients and healthy children: 7.2 +/- 2.4 parts per billion (ppb), 5.5 +/- 2.7 ppb, and 4.2 +/- 2.0 ppb, respectively.Conclusions: An increase in FANo was observed in the presence of symptoms, and proximal airway NO output was correlated with distal obstruction during asthma.