Iji FENO na-agwọ ọrịa asthma
Nkọwa nke exhaled NO na asthma
Atụpụtala ụzọ dị mfe na American Thoracic Society Clinical Practice Guideline maka nkọwa nke FeNO:
- FeNO na-erughị 25 ppb na ndị okenye yana ihe na-erughị 20 ppb n'ime ụmụaka na-erubeghị afọ 12 na-egosi enweghị mbufụt ikuku eosinophilic.
- FeNO karịrị 50 ppb na ndị okenye ma ọ bụ karịa 35 ppb na ụmụaka na-atụ aro mbufụt ikuku eosinophilic.
- Uru FeNO dị n'etiti 25 na 50 ppb n'ime ndị okenye (20 ruo 35 ppb na ụmụaka) kwesịrị ịkọwa nke ọma na ntụnyere ọnọdụ ụlọ ọgwụ.
- FeNO na-arị elu nke nwere mgbanwe karịrị 20 pasent na karịa 25 ppb (20 ppb na ụmụaka) site na ọkwa kwụsiri ike na mbụ na-egosi ịba ụba ikuku eosinophilic, mana enwere ọdịiche dị n'etiti ndị mmadụ n'otu n'otu.
- Mbelata na FeNO karịrị 20 pasent maka ụkpụrụ karịrị 50 ppb ma ọ bụ karịa 10 ppb maka ụkpụrụ na-erughị 50 ppb nwere ike ịdị mkpa na ụlọ ọgwụ.
Nchọpụta na njirimara nke ụkwara ume ọkụ
Global Initiative for Asthma na-adụ ọdụ megide iji FeNO maka nchoputa nke ụkwara ume ọkụ, n'ihi na ọ nwere ike ghara ibuli elu na noneosinophilic asthma ma nwee ike ibuli elu na ọrịa ndị ọzọ karịa ụkwara ume ọkụ, dị ka eosinophilic bronchitis ma ọ bụ nrịanrịa rhinitis.
Dịka ntuziaka maka ọgwụgwọ
Ntuziaka mba ụwa na-atụ aro iji ọkwa FeNO, na mgbakwunye na nyocha ndị ọzọ (dịka, nlekọta ụlọ ọgwụ, akwụkwọ ajụjụ) iji duzie mmalite na nhazi nke ọgwụgwọ nchịkwa ụkwara ume ọkụ.
Jiri na nyocha ụlọ ọgwụ
Nitric oxide e kupụrụ apụ nwere ọrụ dị mkpa na nyocha ụlọ ọgwụ na ọ ga-enye aka n'ịgbasawanye nghọta anyị gbasara ụkwara ume ọkụ, dị ka ihe na-ebute mkparị ụkwara ume ọkụ yana saịtị na usoro eji eme ọgwụ maka ụkwara ume ọkụ.
Jiri na ọrịa iku ume ndị ọzọ
Bronchiectasis na cystic fibrosis
Ụmụaka nwere cystic fibrosis (CF) nwere ọkwa FeNO dị ala karịa njikwa dakọtara nke ọma.N'ụzọ dị iche, otu nnyocha chọpụtara na ndị ọrịa nwere bronchiectasis na-abụghị CF nwere ọkwa dị elu nke FeNO, na ọkwa ndị a jikọtara ya na ogo nke ihe na-adịghị mma pụtara na CT obi.
Ọrịa akpa ume interstitial na sarcoidosis
N'ime nnyocha nke ndị ọrịa nwere scleroderma, a na-ahụta elu ume elu NO n'etiti ndị ọrịa nwere ọrịa ngụgụ interstitial (ILD) ma e jiri ya tụnyere ndị na-enweghị ILD, ebe a na-ahụ ihe dị iche na nyocha ọzọ.N'ime nyocha nke ndị ọrịa 52 nwere sarcoidosis, uru FeNO pụtara bụ 6.8 ppb, nke dị obere karịa ebe mbelata nke 25 ppb ejiri gosipụta mbufụt ụkwara ume ọkụ.
Ọrịa akpa ume na-adịghị ala ala
FENOA na-ebuli ọkwa dị nta na COPD kwụsiri ike, mana ọ nwere ike ịbawanye site na ọrịa siri ike yana n'oge ọgbaghara.Ndị na-ese anwụrụ ugbu a nwere ihe dịka pasent 70 dị ala nke FeNO.N'ime ndị ọrịa nwere COPD, ọkwa FeNO nwere ike ịba uru n'ịmepụta ọnụnọ nke nkwụsị ikuku na-agbanwe agbanwe na ikpebi nzaghachi glucocorticoid, ọ bụ ezie na enyochaghị nke a na nnukwu ule na-enweghị usoro.
Ụkwara variant asthma
FENO nwere izi ezi nchọpụta agafeghị oke na ịkọ nchoputa nke ụkwara variant asthma (CVA) na ndị ọrịa nwere ụkwara na-adịghị ala ala.Na nyocha nhazi nke ọmụmụ 13 (ndị ọrịa 2019), njedebe kachasị mma maka FENO bụ 30 ruo 40 ppb (ọ bụ ezie na e depụtara ụkpụrụ dị ala na ọmụmụ abụọ), na mpaghara nchịkọta n'okpuru usoro ahụ bụ 0.87 (95% CI, 0.83-0.89).Nkọwapụta dị elu ma na-agbanwe agbanwe karịa nghọta.
Eosinophilic bronchitis na-adịghị na-adịghị
N'ime ndị ọrịa nwere bronchitis eosinophilic nonasthmatic (NAEB), sputum eosinophils na FENO na-abawanye n'ọtụtụ dị ka ndị ọrịa nwere ụkwara ume ọkụ.Na nyocha nhazi nke ọmụmụ anọ (ndị ọrịa 390) na ndị ọrịa nwere ụkwara na-adịghị ala ala n'ihi NAEB, ọkwa FENO kacha mma bụ 22.5 ruo 31.7 ppb.Echiche a na-eme atụmatụ bụ 0.72 (95% CI 0.62-0.80) na atụmatụ atụmatụ ya bụ 0.83 (95% CI 0.73-0.90).Ya mere, FENO bara uru iji kwado NAEB, karịa iwepụ ya.
Ọrịa iku ume elu
N'otu nyocha nke ndị ọrịa na-enweghị ọrịa akpa ume na-akpata, nje na-efe efe nke elu iku ume butere mmụba FENO.
Ọbara ọbara mgbali elu
NO na-amata nke ọma dị ka onye ogbugbo pathophysiologic na ọbara mgbali elu nke akpa ume (PAH).Na mgbakwunye na vasodilation, NO na-achịkwa sel endothelial cell proliferation na angiogenesis, ma na-echekwa ahụike vaskụla n'ozuzu ya.N'ụzọ na-akpali mmasị, ndị ọrịa nwere PAH nwere ụkpụrụ FENO dị ala.
FENO yiri ka ọ nwekwara uru amụma, yana ndụ ka mma na ndị ọrịa nwere ịrị elu na ọkwa FENO na ọgwụgwọ (calcium channel blockers, epoprostenol, treprostinil) ma e jiri ya tụnyere ndị na-adịghị.Ya mere, ọkwa FENO dị ala na ndị ọrịa nwere PAH na mmụba na usoro ọgwụgwọ dị irè na-atụ aro na ọ nwere ike ịbụ ihe na-ekwe nkwa biomarker maka ọrịa a.
Arụ ọrụ ciliary nke mbụ
Imi NO dị obere ma ọ bụ na-anọghị na ndị ọrịa nwere isi ọrụ ciliary dysfunction (PCD).A na-atụle iji imi NO na-enyocha PCD n'ime ndị ọrịa nwere nrutu ụlọ ọgwụ nke PCD iche.
Ọnọdụ ndị ọzọ
Na mgbakwunye na ọbara mgbali elu nke akpa ume, ọnọdụ ndị ọzọ metụtara ọkwa FENO dị ala gụnyere hypothermia, na bronchopulmonary dysplasia, yana ịṅụ mmanya, ụtaba, caffeine, na ọgwụ ndị ọzọ.
Oge nzipu: Eprel-08-2022