Yintoni iNitric Oxide?
I-nitric oxide yigesi eveliswa ziiseli ezibandakanyeka ekuvuvukeni okunxulunyaniswa ne-allergy okanye i-eosinophilic asthma.
Yintoni iFeNO?
Uvavanyo lwe-Fractional exhaled Nitric Oxide (FeNO) yindlela yokulinganisa ubungakanani be-nitric oxide kumoya ophumayo. Olu vavanyo lunokunceda ekuxilongweni kwe-asthma ngokubonisa inqanaba lokuvuvukala emiphungeni.
Ukusetyenziswa kwezonyango kwe-FeNO
I-FeNO inokubonelela ngesisombululo esingangenisi ntsholongwane sokuxilongwa kokuqala kwesifo sesifuba, i-ATS kunye ne-NICE ziyincoma njengenxalenye yezikhokelo zabo zangoku kunye neendlela zokuxilonga.
| Abantu abadala | Abantwana | |
| I-ATS (2011) | Phezulu: >50 ppb Phakathi: 25-50 ppb Iphantsi:<25 ppb | Phezulu: >35 ppb Phakathi: 20-35 ppb Iphantsi:<20 ppb |
| I-GINA (2021) | ≥ 20 ppb | |
| I-Nice (2017) | ≥ 40 ppb | >35 ppb |
| Isivumelwano saseScotland (2019) | >40 ppb ICS-naive izigulane >Izigulane ezingama-25 ze-ppb ezithatha i-ICS |
Izifinyezo: I-ATS, i-American Thoracic Society; i-FeNO, i-fractional exhaled nitric oxide; i-GINA, i-Global Initiative ye-Asthma; i-ICS, i-corticosteroid ephefumliweyo; i-NICE, iZiko leSizwe lezeMpilo kunye nokuGqwesa koKhathalelo.
Izikhokelo ze-ATS zichaza amanqanaba aphezulu, aphakathi, kunye naphantsi e-FeNO kubantu abadala njenge >50 ppb, 25 ukuya ku-50 ppb, kunye ne <25 ppb, ngokwahlukeneyo. Ngelixa ebantwaneni, amanqanaba aphezulu, aphakathi, kunye naphantsi e-FeNO achazwa njenge >35 ppb, 20 ukuya ku-35 ppb, kunye ne <20 ppb (Itheyibhile 1). I-ATS icebisa ukusetyenziswa kwe-FeNO ukuxhasa ukuxilongwa kwe-asthma apho kufuneka ubungqina obuchanekileyo, ngakumbi ekuxilongweni kokuvuvukala kwe-eosinophilic. I-ATS ichaza ukuba amanqanaba aphezulu e-FeNO (>50 ppb kubantu abadala kunye ne >35 ppb kubantwana), xa itolikwa kwimeko yeklinikhi, ibonisa ukuba ukuvuvukala kwe-eosinophilic kukho kunye nokuphendula kwe-corticosteroid kwizigulana ezineempawu, ngelixa amanqanaba aphantsi (<25 ppb kubantu abadala kunye <20 ppb kubantwana) enza ukuba la manqanaba angenakwenzeka kwaye aphakathi afanele atolikwe ngononophelo.
Izikhokelo zangoku ze-NICE, ezisebenzisa amanqanaba aphantsi e-FeNO cut-off kune-ATS (Itheyibhile 1), zicebisa ukusetyenziswa kwe-FeNO njengenxalenye yomsebenzi wokuxilongwa apho kuqwalaselwa khona ukuxilongwa kwe-asthma kubantu abadala okanye apho kukho ukungaqiniseki kokuxilongwa ebantwaneni. Amanqanaba e-FeNO aphinda atolikwe kwimeko yeklinikhi kwaye uvavanyo olongezelelweyo, olufana novavanyo lwe-bronchial provocation lunokunceda ukuxilongwa ngokubonisa ukusabela okugqithisileyo kwendlela yomoya. Izikhokelo ze-GINA ziyayivuma indima ye-FeNO ekuchongeni ukudumba kwe-eosinophilic kwi-asthma kodwa okwangoku aziboni indima ye-FeNO kwi-algorithms yokuxilonga i-asthma. I-Scottish Consensus ichaza ukususwa ngokwe-steroid exposure kunye namaxabiso amahle e->40 ppb kwizigulane ezingena-steroid kunye ne->25 ppb kwizigulane ezikwi-ICS.
Ixesha lokuthumela: Matshi-31-2022