UKUSETYENZISWA KWE-FENO KWISIFO SOMBEFU
Ukutolikwa kwe-Exhaled NO kwi-asthma
indlela elula iye yacetywa kwi-American Thoracic Society Clinical Practice Guideline yokutolika i-FeNO:
- I-FeNO engaphantsi kwe-25 ppb kubantu abadala kwaye ngaphantsi kwe-20 ppb kubantwana abangaphantsi kweminyaka eyi-12 ibonisa ukungabikho kwe-eosinophilic airway inflammation.
- I-FeNO enkulu kune-50 ppb kubantu abadala okanye ngaphezulu kwe-35 ppb kubantwana ibonisa ukuvuvukala kwe-eosinophilic airway.
- Amaxabiso e-FeNO phakathi kwe-25 kunye ne-50 ppb kubantu abadala (i-20 ukuya kwi-35 ppb kubantwana) kufuneka icaciswe ngokucokisekileyo ngokubhekiselele kwimeko yeklinikhi.
- Ukunyuka kwe-FeNO kunye neepesenti ze-20 ezitshintshileyo kunye nangaphezulu kwe-25 ppb (20 ppb kubantwana) ukusuka kwinqanaba elizinzile ngaphambili libonisa ukunyuka kwe-eosinophilic airway ukudumba, kodwa kukho ukungafani okubanzi phakathi komntu ngamnye.
- Ukuncipha kwi-FeNO enkulu kuneepesenti ze-20 kumaxabiso angaphezulu kwe-50 ppb okanye ngaphezulu kwe-10 ppb kumaxabiso angaphantsi kwe-50 ppb inokubaluleka kweklinikhi.
Ukuxilongwa kunye nokubonakaliswa kwe-asthma
I-Global Initiative ye-Asthma icebisa ngokuchasene nokusetyenziswa kwe-FeNO yokuxilongwa kwe-asthma, njengoko ingenakuphakanyiswa kwi-asthma ye-noneosinophilic kwaye inokuthi iphakanyiswe kwizifo ngaphandle kwe-asthma, njenge-eosinophilic bronchitis okanye i-rhinitis ye-allergenic.
Njengesikhokelo sonyango
Izikhokelo zamazwe ngamazwe zibonisa ukusebenzisa amanqanaba e-FeNO, ngaphezu kwezinye iimvavanyo (umzekelo, ukhathalelo lweklinikhi, imibuzo) ukukhokela ukuqaliswa kunye nokulungelelaniswa konyango lokulawula i-asthma.
Sebenzisa kuphando lweklinikhi
I-nitric oxide ekhutshweyo inendima ebalulekileyo kuphando lweklinikhi kwaye iya kunceda ekwandiseni ukuqonda kwethu i-asthma, njengezinto ezijongene nokunyuka kwe-asthma kunye neendawo kunye neendlela zokwenza amayeza e-asthma.
SEBENZA KWEZINYE IZIFO ZOKUPILA
I-Bronchiectasis kunye ne-cystic fibrosis
Abantwana abane-cystic fibrosis (CF) banamanqanaba aphantsi e-FeNO kunolawulo oluhambelana ngokufanelekileyo.Ngokwahlukileyo, olunye uphando lufumene ukuba izigulane ezine-non-CF bronchiectasis zinezinga eliphezulu le-FeNO, kwaye la manqanaba aye ahambelana neqondo lokungaqhelekanga elibonakalayo kwi-CT yesifuba.
Isifo semiphunga ye-Interstitial kunye ne-sarcoidosis
Kuphononongo lwezigulane ezine-scleroderma, i-NO ephezulu exhaled yaqatshelwa phakathi kwezigulane ezine-interstitial lung disease (ILD) xa kuthelekiswa nezo zingenayo i-ILD, ngelixa ngokuchaseneyo kwafunyanwa kwesinye isifundo.Kuphononongo lwezigulane ezingama-52 ezine-sarcoidosis, ixabiso eliphakathi kwe-FeNO laliyi-6.8 ppb, elingaphantsi kakhulu kune-cut-point ye-25 ppb esetyenziselwa ukubonisa ukuvutha kwe-asthma.
Isifo semiphunga esingapheliyo
FENOamanqanaba aphakanyiswe kancinci kwiCOPD ezinzile, kodwa anokonyuka ngesifo esibi kakhulu kunye nangexesha lokunyuka.Abatshayayo bangoku banamaqondo angaphantsi kwama-70 ekhulwini e-FeNO.Kwizigulane ezine-COPD, amanqanaba e-FeNO anokuba luncedo ekusekeni ubukho bomqobo wokubuyisela umva kunye nokumisela ukuphendula kwe-glucocorticoid, nangona oku akuzange kuhlolwe kwiimvavanyo ezinkulu ezingahleliwe.
Ukhohlokhohlo olwahlukileyo
I-FENO inokuchaneka okuphakathi kokuxilonga ekucingeni ukuxilongwa kwe-asthma variant (CVA) kwizigulane ezinomkhuhlane ongapheliyo.Kuphononongo olucwangcisiweyo lwezifundo ezili-13 (izigulana ze-2019), uluhlu oluchanekileyo lokusikwa kwe-FENO lwaluyi-30 ukuya kwi-40 ppb (nangona amaxabiso aphantsi aphawulwe kwizifundo ezibini), kwaye indawo yesishwankathelo phantsi kwegophe yayingu-0.87 (95% CI, 0.83-0.89).Ukuchaneka bekuphezulu kwaye kuhambelana ngakumbi kunovakalelo.
Ibronchitis ye-nonasthmatic eosinophilic
Kwizigulane ezine-nonasthmatic eosinophilic bronchitis (NAEB), i-sputum eosinophils kunye ne-FENO zonyuka kuluhlu olufana nezigulane ezine-asthma.Kuphononongo olucwangcisiweyo lwezifundo ezine (izigulane ze-390) kwizigulane ezinokukhwehlela okungapheliyo ngenxa ye-NAEB, amanqanaba afanelekileyo e-FENO okunqunyulwa kwe-22.5 kwi-31.7 ppb.Uvakalelo oluqikelelweyo lwaluyi-0.72 (95% CI 0.62-0.80) kunye nokuqikelelwa ngokuthe ngqo kwi-0.83 (95% CI 0.73-0.90).Ngaloo ndlela, i-FENO iluncedo kakhulu ekuqinisekiseni i-NAEB, kunokuba ungayibandakanyi.
Usulelo oluphezulu lokuphefumla
Kwisifundo esinye sezigulane ngaphandle kwesifo se-pulmonary ephantsi, izifo zentsholongwane eziphezulu zokuphefumula zibangele ukwanda kwe-FENO.
Uxinzelelo lwegazi lwemiphunga
I-NO ibonwa kakuhle njengomlamli we-pathophysiologic kwi-pulmonary arterial hypertension (PAH).Ukongeza kwi-vasodilation, i-NO ilawula ukwanda kweeseli ze-endothelial kunye ne-angiogenesis, kwaye igcina impilo yonke ye-vascular.Okubangela umdla kukuba, izigulane ezine-PAH zinexabiso eliphantsi le-FENO.
I-FENO ibonakala nayo inokubaluleka kokubaluleka, kunye nokuphuculwa kokusinda kwizigulane ezinokunyuka kwinqanaba le-FENO ngonyango (i-calcium channel blockers, epoprostenol, treprostinil) xa kuthelekiswa nalabo abangenayo.Ngaloo ndlela, amanqanaba aphantsi e-FENO kwizigulane ezine-PAH kunye nokuphuculwa kweendlela zonyango ezisebenzayo zibonisa ukuba ingaba yi-biomarker ethembisayo yesi sifo.
Ukungasebenzi kakuhle kweciliary
I-NO yempumlo iphantsi kakhulu okanye ayikho kwizigulane ezine-primary ciliary dysfunction (PCD).Ukusetyenziswa kwe-NO yeempumlo kwisikrini se-PCD kwizigulane ezinokukrokra kweklinikhi ye-PCD kuxoxwa ngokwahlukileyo.
Eminye imiqathango
Ukongeza kwi-pulmonary hypertension, ezinye iimeko ezinxulumene namanqanaba aphantsi e-FENO ziquka i-hypothermia, kunye ne-bronchopulmonary dysplasia, kunye nokusetyenziswa kotywala, icuba, i-caffeine, kunye nezinye iziyobisi.
Ixesha lokuposa: Apr-08-2022