huahana

KA HANA HANA O FENO I KA HAWA

Ka wehewehe ʻana o ka exhaled NO i ka hānō

ua manaʻo ʻia kahi ala maʻalahi ma ka American Thoracic Society Clinical Practice Guideline no ka wehewehe ʻana o FeNO:

• ʻO ka FeNO ma lalo o 25 ppb i nā mākua a emi iho ma lalo o 20 ppb i nā keiki ma lalo o 12 mau makahiki e hōʻike ana i ka nele o ka eosinophilic ea.
• ʻO ka FeNO i ʻoi aku ma mua o 50 ppb i nā pākeke a ʻoi aku paha ma mua o 35 ppb i nā keiki e hōʻike ana i ka mumū eosinophilic ea.
• ʻO nā waiwai o FeNO ma waena o 25 a me 50 ppb i nā pākeke (20 a 35 ppb i nā keiki) pono e wehewehe me ka makaʻala e pili ana i ke kūlana lapaʻau.
• ʻO ka piʻi ʻana o FeNO me ka hoʻololi ʻoi aku ma mua o 20 pakeneka a ʻoi aku ma mua o 25 ppb (20 ppb i nā keiki) mai kahi pae paʻa mua e hōʻike ana i ka piʻi ʻana o ka eosinophilic ea ea, akā aia nā ʻokoʻa ākea ma waena o kēlā me kēia kanaka.
• ʻO ka emi ʻana o FeNO ma mua o 20 pakeneka no nā waiwai ma luna o 50 ppb a ʻoi aku paha ma mua o 10 ppb no nā waiwai ma lalo o 50 ppb he mea koʻikoʻi ke kino.

ʻIke a me ke ʻano o ka hānō

Ke aʻo aku nei ka Global Initiative for Asthma i ka hoʻohana ʻana i ka FeNO no ka ʻike ʻana i ka hānō, no ka mea, ʻaʻole hiki ke hoʻokiʻekiʻe ʻia i ka hānō noneosinophilic a hiki ke hoʻokiʻekiʻe ʻia i nā maʻi ʻē aʻe ma mua o ka hānō, e like me ka eosinophilic bronchitis a i ʻole ka maʻi rhinitis.

Ma ke ʻano he alakaʻi i ka lāʻau lapaʻau

Manaʻo nā alakaʻi o ka honua i ka hoʻohana ʻana i nā pae FeNO, me nā loiloi ʻē aʻe (e laʻa, mālama lapaʻau, nīnau nīnau) e alakaʻi i ka hoʻomaka a me ka hoʻoponopono ʻana i ka lāʻau hoʻoponopono hānō.

Hoʻohana i ka noiʻi lapaʻau

He kuleana koʻikoʻi ko exhaled nitric oxide i ka noiʻi lāʻau lapaʻau a e kōkua paha ia i ka hoʻonui ʻana i ko mākou ʻike no ka hānō, e like me nā kumu no ka exacerbations hānō a me nā pūnaewele a me nā hana o nā lāʻau lapaʻau no ka hānō.

Hoohana i na ma'i hanu e ae

ʻO Bronchiectasis a me ka cystic fibrosis

ʻO nā keiki me ka cystic fibrosis (CF) he haʻahaʻa ka pae FeNO ma mua o nā mana kūpono.I ka hoʻokaʻawale ʻana, ua ʻike ʻia kahi noiʻi ua piʻi ka pae o FeNO i nā poʻe maʻi me ka bronchiectasis non-CF, a ua hoʻopili ʻia kēia mau pae me ke kiʻekiʻe o ka abnormality i ʻike ʻia ma ka umauma CT.

ʻO ka maʻi māmā interstitial a me ka sarcoidosis

Ma kahi noiʻi o nā poʻe maʻi me ka scleroderma, ua ʻike ʻia ka NO exhaled kiʻekiʻe ma waena o nā poʻe maʻi me ka maʻi interstitial lung (ILD) i hoʻohālikelike ʻia me ka poʻe me ka ILD ʻole, ʻoiai ua ʻike ʻia ka ʻaoʻao ma kahi noiʻi ʻē aʻe.Ma ke aʻo ʻana o 52 mau maʻi me ka sarcoidosis, ʻo ka nui o ka waiwai FeNO he 6.8 ppb, ʻoi aku ka liʻiliʻi ma mua o ka ʻoki ʻia o 25 ppb i hoʻohana ʻia e hōʻike i ka ʻeha hānō.

ʻO ka maʻi obstructive pulmonary

FE_NOUa hoʻokiʻekiʻe ʻia nā pae i ka COPD paʻa, akā hiki ke hoʻonui me ka maʻi ʻoi aku ka nui a i ka wā exacerbations.Loaʻa i nā mea puhi puhi i kēia manawa ma kahi o 70 pakeneka haʻahaʻa o FeNO.I nā poʻe maʻi me COPD, hiki ke hoʻohana ʻia nā pae FeNO i ka hoʻokumu ʻana i ke alo o ka ea e hoʻohuli ʻia a me ka hoʻoholo ʻana i ka pane ʻana o ka glucocorticoid, ʻoiai ʻaʻole i loiloi ʻia kēia i nā hoʻokolohua nui randomized.

ʻO ka hānō ʻano like ʻole

Loaʻa i ka FENO ka pololei diagnostic i ka wānana ʻana i kahi hōʻailona o ka maʻi hānō ʻano like ʻole (CVA) i nā poʻe maʻi me ka ʻaʻa mau.I loko o kahi loiloi ʻōnaehana o 13 mau haʻawina (2019 mau maʻi), ʻo ka palena ʻoki ʻoki maikaʻi loa no FENO ʻo 30 a 40 ppb (ʻoiai ua ʻike ʻia nā haʻahaʻa haʻahaʻa ma nā haʻawina ʻelua), a ʻo ka wahi hōʻuluʻulu ma lalo o ka pihi ʻo 0.87 (95% CI, 0.83-0.89).Ua ʻoi aku ka kiʻekiʻe a ʻoi aku ka paʻa o ka kikoʻī ma mua o ka naʻau.

Nonasthmatic eosinophilic bronchitis

I nā poʻe maʻi me ka bronchitis eosinophilic nonasthmatic (NAEB), hoʻonui ʻia nā sputum eosinophils a me FENO ma kahi ākea e like me nā maʻi me ka hānō.I loko o kahi loiloi hoʻonohonoho o nā haʻawina ʻehā (390 mau maʻi) i nā maʻi me ka maʻi maʻi maʻi ma muli o NAEB, ʻoi aku ka maikaʻi o FENO ʻoki ʻia nā pae he 22.5 a 31.7 ppb.ʻO ka sensitivity i manaʻo ʻia ʻo 0.72 (95% CI 0.62-0.80) a ʻo 0.83 ka mea kikoʻī (95% CI 0.73-0.90).No laila, ʻoi aku ka maikaʻi o FENO e hōʻoia i ka NAEB, ma mua o ka haʻalele ʻana.

ʻO nā maʻi hanu luna

Ma hoʻokahi noiʻi ʻana o nā maʻi me ka ʻole o ka maʻi pulmonary i lalo, ua hoʻonui ʻia ka FENO i nā maʻi ʻeha o luna.

ʻO ke kiʻekiʻe o ka pulmonary hypertension

ʻIke maikaʻi ʻia ʻo NO ma ke ʻano he mea hoʻoponopono pathophysiologic i ka pulmonary arterial hypertension (PAH).Ma waho aʻe o ka vasodilation, NO ka hoʻoponopono i ka hoʻonui ʻana o ka cell endothelial a me ka angiogenesis, a mālama i ke olakino vascular holoʻokoʻa.ʻO ka mea hoihoi, he haʻahaʻa ko FENO nā mea maʻi me ka PAH.

Me he mea lā he manaʻo wānana ka FENO, me ka hoʻomaikaʻi ʻana i ke ola ʻana i nā poʻe maʻi i piʻi i ka pae FENO me ka lāʻau lapaʻau (nā mea hoʻopaʻa kaila calcium, epoprostenol, treprostinil) i hoʻohālikelike ʻia me ka poʻe ʻaʻole.No laila, ʻo nā haʻahaʻa haʻahaʻa FENO i nā maʻi me PAH a me ka hoʻomaikaʻi ʻana me nā lāʻau lapaʻau maikaʻi e hōʻike ana he biomarker hoʻohiki no kēia maʻi.

ʻO ka hana ʻino ciliary mua

He haʻahaʻa loa ka Nasal NO a i ʻole i ka poʻe maʻi me ka maʻi ciliary mua (PCD).ʻO ka hoʻohana ʻana i ka ihu NO i ka nānā ʻana no ka PCD i nā poʻe maʻi me ka kānalua o ka PCD e kūkākūkā kaʻawale.

Nā kūlana ʻē aʻe

Ma waho aʻe o ka pulmonary hypertension, ʻo nā kūlana ʻē aʻe e pili ana i nā pae haʻahaʻa FENO e pili ana i ka hypothermia, a me ka bronchopulmonary dysplasia, a me ka hoʻohana ʻana i ka waiʻona, ka paka, ka caffeine, a me nā lāʻau lapaʻau ʻē aʻe.