呼出气一氧化氮检测在支气管哮喘诊治中的临床应用进展  

Progress in the clinical application of fractional exhaled nitric oxide in diagnosis and treatment of bronchial asthma

作　　者：汪慧英[1] WANG Huiying(Department of Allergy and Clinical Immunology,the Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China)

机构地区：[1]浙江大学医学院附属第二医院过敏(变态反应)科,浙江杭州310009

出　　处：《新医学》2024年第10期764-770,共7页Journal of New Medicine

基　　金：国家中医药管理局科技司-浙江省中医药管理局共建科技计划项目重大项目(GZY-ZJ-KJ-23027);浙江省自然科学基金探索Y类项目(YLY20H260005)。

摘　　要：呼出气一氧化氮(FeNO)是一种2型炎症标志物,在体内主要由气道上皮的一氧化氮合成酶(NOS)以L-赖氨酸和氧气为底物合成。2型炎症细胞因子白介素(IL)-4和IL-13可以上调诱导型NOS,造成一氧化氮的大量产生,并在支气管哮喘的发病中起到重要作用。FeNO与气道炎症和重塑、肺功能的下降、嗜酸性粒细胞的浸润等密切相关。临床上FeNO的应用主要包括支气管哮喘的诊断、预测患者对激素的治疗反应以及依从性评估。近年来,FeNO在生物制剂的选择上也起到指示作用。作为一种无创、简便、经济的检测手段,FeNO在支气管哮喘诊治中的作用将会得到更多的认识和应用。Fractional exhaled nitric oxide(FeNO)is a biomarker of type 2 inflammation,and produced by nitric oxide synthase(NOS)expressed on the airway epithelial cells,with the substrates of L-arginine and oxygen.Type 2 cytokines such as interleukin(IL)-4 and IL-13 can up-regulate inducible NOS,which results in the abundant production of NO.NO plays an important role in the pathogenesis of bronchial asthma,and is closely associated with the airway inflammation and remodeling,reduction of lung function and eosinophil infiltration,etc.The technique of FeNO test is applied in the clinical diagnosis of asthma,predicting the response to steroids and evaluating the compliance of asthmatic patients.In recent years,it also plays a guiding role in choosing the optimal biologics for individual therapy for patients of asthma.As a non-invasive,convenient,and economical method,the role of FeNO in the diagnosis and treatment of asthma will be better understood and applied.

关 键 词：呼出气一氧化氮 2型炎症 支气管哮喘 白介素-4 白介素-13 

分 类 号：R562.25[医药卫生—呼吸系统]