呼出气一氧化氮分析在慢性阻塞性肺疾病中的研究进展

Review of fractional exhaled nitric oxide analysis in chronic obstructive pulmonary disease

呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)检测是一种定量、非侵入性、简便安全的气道炎症测量方法,随着美国胸科学会/欧洲呼吸学会指南对测量技术的标准化,FeNO作为哮喘的管理工具之一,已被广泛用于临床检测以嗜酸性粒细胞浸润为主的气道炎症,评估吸入糖皮质激素的疗效。而对于慢性阻塞性肺疾病(慢阻肺)而言,虽然已开展了一些初步研究,但现有研究结论存在诸多争议和冲突,单一FeNO在慢阻肺中的临床应用价值尚难定论。然而,通过模拟肺内NO气体交换构建的NO动力学模型对FeNO进行扩展分析能够获取更多信息,有助于定位气道炎症,为慢阻肺的评估和管理增加新的维度。本文回顾近年扩展FeNO分析在气道疾病中的相关研究,归纳总结FeNO参数在慢阻肺诊疗中的研究现况。

Measurement of fractional exhaled nitric oxide(FeNO)is a quantitative,non-invasive,simple and safe method for measuring airway inflammation.With the standardization of measurement techniques in the ATS/ERS guidelines,FeNO has been widely used in asthma for detecting eosinophilic airway inflammation,monitoring and evaluating the response of inhaled corticosteroids.For chronic obstructive pulmonary disease(COPD),there are a lot of controversies and conflicts in the previous study.The value of FeNO in COPD is still unclear.Now,the modelling of NO dynamics of the lung can give more information than a single FeNO value.It is helpful to locate airway inflammation and give a new insight to the assessment and management of COPD.Based on the recent studies about extended FeNO analysis in airway diseases,this review will show the present situation of FeNO parameter in the diagnosis and treatment of COPD.