上下气道一氧化氮检测在持续性变应性鼻炎患者气道炎症评价中的意义

目的通过对持续性变应性鼻炎（allergic rhinitis,AR）患者上、下气道一氧化氮含量（ni-tric oxide,NO）的检测,为AR患者的临床诊断、治疗及病情的评估提供帮助。方法使用NO检测系统对67例持续性AR患者（其中轻度持续性AR患者28例,中重度持续性AR患者39例）进行上、下气道呼出NO含量测定,同时选择30例健康成人作为对照组。并采用肺功能仪评估肺功能。结果①持续性AR患者上气道NO含量（88.4±3.5）ppb,对照组上气道NO含量（84.2±2.6）ppb;持续性AR患者上气道NO含量与正常对照组相比,差异无统计学意义（P〉0.05）。②持续性AR患者下气道NO含量为（44.2±3.6）ppb,对照组下气道NO含量为（15.7±5.2）ppb;持续性AR患者下气道NO含量显著高于正常对照组,差异具有统计学意义（P=0.000）。③轻度持续性AR患者下气道NO含量（22.7±9.9）ppb,中重度持续性AR患者下气道NO含量（59.7±4.0）ppb;中重度持续性AR患者下气道NO含量明显高于轻度AR患者,差异具有统计学意义（P=0.000）。④持续性AR患者上、下气道呼出NO含量之间不存在相关性（P=0.354）。结论 NO检测方便、快捷,可以及时监测持续性AR患者下气道炎症程度,对于临床尚无下气道炎症临床症状、肺功能正常,但下气道呼出NO升高的持续性AR患者,可以将下气道NO作为气道炎症及病情的监测指标,指导临床治疗。上气道NO检测在变应性鼻炎患者气道炎症评价中的意义有待进一步研究评价。

Significance of nitric oxide detection in evaluation of airway inflammation in persistent allergic rhinitis

Objective To provide assistance for the diagnosis, treatment and evaluation of illness state via detecting the level of nitric oxide （ NO ） in airways of patients with persistent allergic rhinitis （ PAR）. Methods NO concentrations were detected with NIOX analysis system in upper and lower airways of 67 PAR patients. Of them, 28 cases were mild and 39 were moderate to severe. 30 healthy adults were chosen as control. The pulmonary function was measured with Pony FX analysis system. Results ①The NO concentrations of upper airway of PAR group and the control group were （ 88.4 ± 3.5 ） ppb and （ 84.2 ± 2.6 ） ppb respectively, and the difference was statistically insignificant （ P 〉 0 . 0 0 5 ） . ②The NO concentration of lower airway in PAR group was （ 4 4 . 2 ±3.6 ） ppb, which was much higher than that of the control group （ 15.7 ± 5.2 ） ppb with statistically significant difference （ P = 0. 000 ）. ③ In the PAR group, the NO concentrations of lower airway in the mild subgroup and moderate to severe subgroup were （22.7 ± 9.9 ） ppb and （59.7 ± 4.0 ） ppb respectively, and the difference was statistically significant （ P = 0. 000 ）. ④ There was no correlation between NO concentrations of upper and lower airway in PAR group. Conclusion With advantage of convenient and prompt monitoring the inflammatory degree of lower airway in PAR, concentration of lower airway NO may be used as an index for the management and treatment of PAR patients who have no symptoms of lower respiratory inflammation with normal pulmonary function but with increased lower airway NO concentration. Further study is required on the significance of upper airway NO measurement in estimating airway inflammation of AR.