mankhwala

KUGWIRITSA NTCHITO FENO PACHIKHALIDWE PA mphumu

Kutanthauzira kwa exhaled NO mu mphumu

njira yosavuta yaperekedwa mu American Thoracic Society Clinical Practice Guideline kuti amasulire FeNO:

• FeNO yochepera 25 ppb mwa akulu ndi osakwana 20 ppb mwa ana osakwana zaka 12 amatanthauza kusakhalapo kwa kutupa kwa eosinophilic airway.
• FeNO wamkulu kuposa 50 ppb mwa akulu kapena oposa 35 ppb mwa ana akuwonetsa kutupa kwa eosinophilic airway.
• Miyezo ya FeNO pakati pa 25 ndi 50 ppb mwa akulu (20 mpaka 35 ppb mwa ana) iyenera kutanthauziridwa mosamala potengera momwe wodwalayo alili.
• FeNO ikukwera yokhala ndi kusintha kwakukulu kuposa 20 peresenti komanso kuposa 25 ppb (20 ppb mwa ana) kuchokera pamlingo wokhazikika kale ikusonyeza kuwonjezeka kwa kutupa kwa eosinophilic airway, koma pali kusiyana kwakukulu pakati pa anthu.
• Kutsika kwa FeNO kuposa 20 peresenti pamtengo wopitilira 50 ppb kapena kuposa 10 ppb pamitengo yochepera 50 ppb kungakhale kofunikira pazachipatala.

Kuzindikira ndi mawonekedwe a mphumu

Global Initiative for Asthma imalangiza motsutsana ndi kugwiritsidwa ntchito kwa FeNO pozindikira kuti ali ndi mphumu, chifukwa sichikhoza kukwezedwa mu mphumu ya noneosinophilic ndipo ikhoza kukwezedwa mu matenda ena osati mphumu, monga eosinophilic bronchitis kapena allergenic rhinitis.

Monga chitsogozo chamankhwala

Malangizo apadziko lonse lapansi akuwonetsa kugwiritsa ntchito milingo ya FeNO, kuphatikiza pakuwunika kwina (mwachitsanzo, chisamaliro chachipatala, mafunso) kutsogolera kuyambitsa ndi kusintha kwa chithandizo cha mphumu.

Gwiritsani ntchito kafukufuku wamankhwala

Exhaled nitric oxide ili ndi gawo lofunikira pakufufuza kwachipatala ndipo ingathandize kukulitsa kumvetsetsa kwathu kwa mphumu, monga zomwe zimayambitsa kukulitsa kwa mphumu ndi malo ndi njira zopangira mankhwala a mphumu.

GWIRITSANI NTCHITO MATENDA ENA OPUMIRA

Bronchiectasis ndi cystic fibrosis

Ana omwe ali ndi cystic fibrosis (CF) amakhala ndi milingo yotsika ya FeNO kuposa zowongolera zofananira.Mosiyana ndi zimenezi, kafukufuku wina anapeza kuti odwala omwe sanali a CF bronchiectasis anali okwera kwambiri a FeNO, ndipo milingo imeneyi inali yogwirizana ndi kuchuluka kwa matenda omwe amawonekera pachifuwa cha CT.

Matenda a m'mapapo ndi sarcoidosis

Pakufufuza kwa odwala omwe ali ndi scleroderma, NO yotuluka kwambiri idadziwika pakati pa odwala omwe ali ndi matenda a interstitial mapapo (ILD) poyerekeza ndi omwe alibe ILD, pomwe zosiyana zidapezeka mu kafukufuku wina.Pakufufuza kwa odwala 52 omwe ali ndi sarcoidosis, tanthauzo la FeNO linali 6.8 ppb, lomwe ndi locheperapo kuposa 25 ppb lomwe limagwiritsidwa ntchito kutanthauza kutupa kwa mphumu.

Matenda a m'mapapo osatha

FE_NOMiyezo imakhala yokwera pang'ono mu COPD yokhazikika, koma imatha kuwonjezeka ndi matenda oopsa komanso panthawi yowonjezereka.Osuta amakono ali ndi pafupifupi 70 peresenti yochepa ya FeNO.Odwala omwe ali ndi COPD, masitepe a FeNO angakhale othandiza pokhazikitsa kukhalapo kwa kutsekeka kwa mpweya wosinthika ndikuzindikira kuyankha kwa glucocorticoid, ngakhale kuti izi sizinayesedwe m'mayesero akuluakulu osasinthika.

Chifuwa chosiyana ndi mphumu

FENO ili ndi kulondola kwapakatikati pakulosera za matenda a chifuwa cha variant asthma (CVA) mwa odwala omwe ali ndi chifuwa chachikulu.Mukuwunika mwadongosolo maphunziro 13 (odwala a 2019), njira yabwino yodulira FENO inali 30 mpaka 40 ppb (ngakhale zotsika zidadziwika m'maphunziro awiri), ndipo gawo lachidule lomwe linali pansi pa piritsi linali 0.87 (95% CI, 0.83-0.89).Kutsimikizika kunali kokwezeka komanso kosasinthasintha kuposa kukhudzika.

Nonasthmatic eosinophilic bronchitis

Odwala omwe ali ndi vuto la mphumu la nonasthmatic eosinophilic bronchitis (NAEB), sputum eosinophils ndi FENO amawonjezeka mofanana ndi odwala mphumu.Mukuwunika mwadongosolo maphunziro anayi (odwala 390) mwa odwala omwe ali ndi chifuwa chachikulu chifukwa cha NAEB, milingo yabwino kwambiri ya FENO yodulidwa inali 22.5 mpaka 31.7 ppb.Kukhudzika koyerekeza kunali 0.72 (95% CI 0.62-0.80) ndipo kuyerekezedwa kwake kunali 0.83 (95% CI 0.73-0.90).Chifukwa chake, FENO ndiyothandiza kwambiri kutsimikizira NAEB, kuposa kuyipatula.

Matenda a m'mwamba mwa kupuma

Pakafukufuku wina wa odwala omwe alibe matenda a m'mapapo, matenda opatsirana a mavairasi apamwamba adayambitsa kuwonjezeka kwa FENO.

Matenda oopsa a m'mapapo

NO amadziwika bwino ngati mkhalapakati wa pathophysiologic mu pulmonary arterial hypertension (PAH).Kuphatikiza pa vasodilation, NO imayang'anira kuchuluka kwa endothelial cell ndi angiogenesis, ndikusunga thanzi la mtima wonse.Chosangalatsa ndichakuti odwala omwe ali ndi PAH amakhala ndi ma FENO otsika.

FENO ikuwoneka kuti ilinso ndi tanthauzo lachidziwitso, ndi kupulumuka kwabwino kwa odwala omwe ali ndi kuwonjezeka kwa mlingo wa FENO ndi mankhwala (calcium channel blockers, epoprostenol, treprostinil) poyerekeza ndi omwe alibe.Chifukwa chake, milingo yotsika ya FENO mwa odwala omwe ali ndi PAH komanso kusintha kwamankhwala othandizira kumawonetsa kuti ikhoza kukhala chizindikiro chodalirika cha matendawa.

Kuwonongeka koyambirira kwa ciliary

Mphuno NO ndi yotsika kwambiri kapena kulibe kwa odwala omwe ali ndi vuto lalikulu la ciliary (PCD).Kugwiritsiridwa ntchito kwa m'mphuno NO kuwonetsetsa kwa PCD kwa odwala omwe akukayikira zachipatala za PCD kumakambidwa mosiyana.

Zinthu zina

Kuphatikiza pa matenda oopsa a m'mapapo, zinthu zina zomwe zimagwirizanitsidwa ndi kuchepa kwa FENO zimaphatikizapo hypothermia, ndi bronchopulmonary dysplasia, komanso kugwiritsa ntchito mowa, fodya, caffeine, ndi mankhwala ena.