鼻呼出气一氧化氮的检测及临床应用

doi:10.6040/j.issn.1673-3770.1.2019.026

摘要/Abstract

摘要：

一氧化氮（NO）是L-精氨酸被一氧化氮合成酶催化后所生成的产物，是气道炎症的标志物之一。鼻部NO（nNO）可构成鼻腔的防御屏障，保持鼻窦的相对无菌。临床上最常用的nNO检测方法是利用鼻塞式探头置于前鼻孔直接采集鼻呼出气。目前nNO已用于囊性纤维化及原发性纤毛运动障碍的筛查诊断，由于nNO与鼻窦窦口的阻塞程度等多种因素相关，动态监测治疗前后的nNO值及联合口呼出气一氧化氮（FeNO）检查对早期发现上下气道嗜酸粒细胞性炎症更有临床应用价值。

关键词: 一氧化氮, 鼻部一氧化氮, 呼出气一氧化氮, 检测, 临床应用

Abstract:

Nitric oxide (NO) is synthesized from arginine by the enzyme family NO synthases. NO is an endogenous modulator of airway function. NO from the nose can constitute a nasal defensive barrier, and keep the sinuses relatively sterile. The most commonly clinical detection of nasal nitricc oxide (nNO) is to directly collect NO with a nasal plug probe placed in the anterior nostril. nNO has been used for the screening diagnosis of cystic fibrosis and primary ciliary dyskinesia. However, nNO is related to many influences such as the plugged extent of the sinus. Dynamic monitoring nNO before and after treatment, and combination with frictional exhaled nitric oxide (FeNO）examination to early detect eosinophilic inflmmation in the upper and lower airways are more clinically valuable.

Key words: Nitric oxide, Nasal nitric oxide, Frictional exhaled nitric oxide, Detection, Clinical application

中图分类号:

R765

陈芝文,程雷. 鼻呼出气一氧化氮的检测及临床应用[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 124-128.

Zhiwen CHEN,Lei CHENG. Detection and clinical application of nasal nitric oxide[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(3): 124-128.

参考文献 28

1	DweikRA, BoggsPB, ErzurumSC, et al. An Official ATS Clinical Practice Guideline:Interpretation of Exhaled Nitric Oxide Levels (FENO) for Clinical Applications[J]. Am J Respir Crit Care Med, 2011, 184(5): 602-615. doi: 10.1164/rccm.912011ST. doi: 10.1164/rccm.912011ST
2	LeeM, WangC, JinSW, et al. Expression of human inducible nitric oxide synthase in response to cytokines is regulated by hypoxia-inducible factor-1[J]. Free Radic Biol Med, 2019, 130: 278-287. doi: 10.1016/j.freeradbiomed.2018.10.441. doi: 10.1016/j.freeradbiomed.2018.10.441
3	Gustafsson LE, LeoneAM, PerssonMG, et al. Endogenous nitric oxide is present in the exhaled air of rabbits, guinea pigs and humans[J]. Biochem Biophys Res Commun, 1991, 181(2): 852-857.doi:10.1016/0006-291x(91)91268-h. doi: 10.1016/0006-291x(91)91268-h
4	LundbergJO, Farkas-SzallasiT, WeitzbergE, et al. High nitric oxide production in human paranasal sinuses[J]. Nat Med, 1995, 1(4): 370-373. doi: 10.1038/nm0495-370. doi: 10.1038/nm0495-370
5	WeitzbergE, LundbergJO. Humming greatly increases nasal nitric oxide[J]. Am J Respir Crit Care Med, 2002, 166(2): 144-145. doi: 10.1164/rccm.200202-138BC. doi: 10.1164/rccm.200202-138BC
6	王桂香, 王蓬鹏, 唐力行, 等. 变应性鼻炎儿童呼出气一氧化氮浓度测定方法初探[J]. 山东大学耳鼻喉眼学报, 2016, 30(1): 14-16. doi: 10.604/j.issn.1673-3770.0.2015.328. doi: 10.604/j.issn.1673-3770.0.2015.328
	WANGGuixiang, WANGPengpeng, TANGLixing, et al. Study on measurement of nasal nitric oxide in children with allergic rhinitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2016, 30(1): 14-16. doi: 10.604/j.issn.1673-3770.0.2015.328. doi: 10.604/j.issn.1673-3770.0.2015.328
7	AntosovaM, MokraD, TonhajzerovaI, et al. Nasal nitric oxide in healthy adults-reference values and affecting factors[J]. Physiol Res, 2017, 66(Supple.2): S247-S255.PMID: 28937239.
8	RenL, ZhangW, ZhangY, et al. Nasal nitric oxide is correlated with nasal patency and nasal symptoms[J]. Allergy Asthma Immunol Res, 2019, 11(3): 367-380. doi: 10.4168/aair.2019.11.3.367. doi: 10.4168/aair.2019.11.3.367
9	American Thoracic Society; European Respiratory Society. ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005[J]. Am J Respir Crit Care Med, 2015, 171(8): 912-930. doi: 10.1164/rccm.200406-710ST. doi: 10.1164/rccm.200406-710ST
10	OlinAC, AldenbrattA, EkmanA, et al. Increased nitric oxide in exhaled air after intake of a nitrate-rich meal[J]. Respir Med, 2001, 95(2): 153-158. doi: 10.1053/rmed. 2000.1010. doi: 10.1053/rmed. 2000.1010
11	StrubenVMD, WieringaMH, MantinghCJ, et al. Nasal NO: normal values in children age 6 through to 17 years[J]. Eur Respir J, 2005, 26(3): 453-457. doi: 10.1183/09031936.05.00015205. doi: 10.1183/09031936.05.00015205
12	ZhouH, ZouB, HazuchaM, et al. Nasal nitric oxide and lifestyle exposure to tobacco smoke[J]. Ann Otol Rhinol Laryngol, 2011, 120(7): 455-459. doi: 10.1177/0003489-41112000706. doi: 10.1177/0003489-41112000706
13	LeeKJ, ChoSH, LeeSH, et al. Nasal and exhaled nitric oxide in allergic rhinitis[J]. Clin Exp Otorhinolaryngol, 2012, 5(4): 228-233. doi: 10.3342/ceo.2012.4.228. doi: 10.3342/ceo.2012.4.228
14	WangPP, WangGX, GeWT, et al. Nasal nitric oxide in allergic rhinitis in children and its relationship to severity and treatment[J]. Allergy Asthma Clin Immunol, 2017, 13: 20. doi: 10.1186/s13223-017-0191-z.eCollection 2017. doi: 10.1186/s13223-017-0191-z.eCollection 2017
15	MoodyA, FergussonW, WellsA, et al. Increased nitric Oxide production in the respiratory tract in asymptomatic pacific islanders: an association with skin prick reactivity to house dust mite[J]. J Allergy Clin lmmunol, 2000, 105(5): 895-899. doi: 10.1037//mai.2000.105318. doi: 10.1037//mai.2000.105318
16	SuojalehtoH, VehmasT, KennedyDW, et al. Nasal nitric oxide is dependent on sinus obstruction in allergic rhinitis[J]. Laryngoscope, 2014, 124(6): E213-218. doi: 10. 1002/lary.24590. doi: 10. 1002/lary.24590
17	ProundD. Nitric oxide and the common cold[J]. Cuur Opin Allergy Clin Immunol, 2005, 5(1): 37-42.PMID: 15643342.
18	DabholkarYG, SaberwalAA, VelankarHK, et al. Correlation of nasal nitric oxide measurement with computed tomography findings in chronic rhinosinusitis[J]. Indian J Otolaryngol Head Neck Surg, 2014, 66(1): 92-96. doi: 10.1007/s12070-013-0689-8. doi: 10.1007/s12070-013-0689-8
19	AutioTJ, KosekenkorvaT, LeinoTK, et al. Longitudinal analysis of inflammatory biomarkers during acute rhinosinusitis[J]. Larynqoscope, 2017, 127(2): E55-E61. doi: 10. 1002/lary.26344. doi: 10. 1002/lary.26344
20	BommaritoL, GuidaG, HefflerE, et al. Nasal nitric oxide concentration in suspected chronic rhinosinusitis[J]. Ann Allergy Asthma Immunol, 2008, 101(4): 358-362. doi: 10.1016/S1081-1206(10)60310-9. doi: 10.1016/S1081-1206(10)60310-9
21	白银, 尤少华, 张静, 等. 鼻腔呼出气一氧化氮无创检测及其临床意义[J]. 中华耳鼻咽喉头颈外科杂志, 2014, 49(4): 341-346. doi: 10.3760/cma.j.issn.1673-0860.2014. 04.018 doi: 10.3760/cma.j.issn.1673-0860.2014. 04.018
22	KrantzC, JansonC, HollsingA, et al. Exhaled and nasal nitric oxide in relation to lung fuction, blood cell counts and disease characteristics in cystic fibrosis[J]. J Breath Res, 2017, 11(2): 026001. doi:10.1088/1752-7163/aa61aa. doi: 10.1088/1752-7163/aa61aa
23	KeenC, OlinAC, EdentoftA, et al. Airway nitric oxide in patients with cystic fibrosis is associated with pancreatic function, Psedomonas infection, and polyunsaturated fatty acids[J]. Chest, 2007, 131(16): 1857-1864. doi: 10. 1378/chest.06-2635. doi: 10. 1378/chest.06-2635
24	LeighMW, HazuchaMJ, ChawlaKK, et al. Standardizing nasal nitric oxide measurement as a test for primary ciliary dyskinesia[J]. Ann Am Thorac Soc, 2013, 10(6): 574-581. doi: 10.1513/AnnalsATS.201305-110OC. doi: 10.1513/AnnalsATS.201305-110OC
25	RademacherJ, BuckA, SchwerkN, et al. Nasal nitric oxide measurement and a modified PICADAR score for the screening of primary ciliary dyskinesia in adults with bronchiectasis[J]. Pneumologie, 2017, 71(8): 543-548. doi: 10.1055/s-0043-111909. doi: 10.1055/s-0043-111909
26	ShapiroAJ, DavisSD, PolineniD, et al. Diagnosis of primary ciliary dyskinesia. an official American thoracic society clinical practice guideline[J]. Am J Respir Crit Care Med, 2018, 197(12): e24-e39. doi: 10.1164/rccm. 2018-05-0819ST. doi: 10.1164/rccm. 2018-05-0819ST
27	ShapiroAJ, JosephsonM, RosenfeldM, et al. Accuracy of nasal nitric oxide measurement as a diagnostic test for primary ciliary dyskinesia: a systematic review and meta-analysis[J]. Ann Am Thorac Soc, 2017, 14(7): 1184-1196. doi: 10.1513/AnnalsATS.201701-062SR. doi: 10.1513/AnnalsATS.201701-062SR
28	中华医学会呼吸病学分会哮喘学组. 上-下气道慢性炎症性疾病联合诊疗与专家共识[J]. 中华医学杂志, 2017, 97(26): 2001-2022. doi: 10.3760/cma.j.issn.0376-2491.2017.26.00 doi: 10.3760/cma.j.issn.0376-2491.2017.26.00

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