samfurori

AMFANIN SAUKI NA FENO A CIKIN ASMA

Fassarar fitar numfashi NO a cikin asma

An gabatar da hanya mafi sauƙi a cikin Jagoran Ayyukan Clinical na Ƙungiyar Thoracic na Amurka don fassarar FeNO:

• A FeNO kasa da 25 ppb a cikin manya da ƙasa da 20 ppb a cikin yara masu ƙasa da shekaru 12 yana nuna rashin kumburin iska na eosinophilic.
• FeNO mafi girma fiye da 50 ppb a cikin manya ko fiye da 35 ppb a cikin yara yana nuna kumburin iska na eosinophilic.
• Darajar FeNO tsakanin 25 zuwa 50 ppb a cikin manya (20 zuwa 35 ppb a cikin yara) yakamata a fassara shi cikin taka tsantsan tare da la'akari da yanayin asibiti.
• FeNO mai tasowa tare da canji fiye da 20 bisa dari kuma fiye da 25 ppb (20 ppb a cikin yara) daga matakin da ya dace a baya yana nuna karuwar kumburin iska na eosinophilic, amma akwai bambance-bambance tsakanin mutum-mutumi.
• Ragewar FeNO sama da kashi 20 na ƙima sama da 50 ppb ko fiye da 10 ppb akan ƙimar ƙasa da 50 ppb na iya zama mahimmanci a asibiti.

Ganewa da halayyar asma

The Global Initiative for Asthma yana ba da shawara game da amfani da FeNO don gano cutar asma, saboda ƙila ba za a ɗaga shi a cikin asma na noneosinophilic ba kuma yana iya haɓakawa a cikin cututtukan da ban da asma, irin su eosinophilic mashako ko rashin lafiyan rhinitis.

A matsayin jagora ga far

Jagororin ƙasa da ƙasa suna ba da shawarar yin amfani da matakan FeNO, ban da wasu ƙima (misali, kulawar asibiti, tambayoyin tambayoyi) don jagorantar farawa da daidaitawa na maganin asma.

Yi amfani da bincike na asibiti

Nitric oxide da aka fitar yana da muhimmiyar rawa a cikin bincike na asibiti kuma wataƙila zai taimaka wajen faɗaɗa fahimtarmu game da asma, kamar abubuwan da ke haifar da ɓarnawar asma da wuraren da hanyoyin aiwatar da magunguna don asma.

AMFANI DA SAURAN CUTUTTUKA

Bronchiectasis da cystic fibrosis

Yaran da ke da cystic fibrosis (CF) suna da ƙananan matakan FeNO fiye da yadda aka dace da sarrafawa.Sabanin haka, binciken daya ya gano cewa marasa lafiya da ba CF bronchiectasis ba suna da matakan FeNO masu girma, kuma waɗannan matakan sun danganta da matakin rashin daidaituwa a kan kirji CT.

Ciwon huhu na interstitial da sarcoidosis

A cikin nazarin marasa lafiya tare da scleroderma, an lura da mafi girma exhaled NO a tsakanin marasa lafiya da interstitial huhu cuta (ILD) idan aka kwatanta da wadanda ba tare da ILD, yayin da aka samu akasin haka a wani binciken.A cikin nazarin marasa lafiya 52 tare da sarcoidosis, ma'anar ƙimar FeNO shine 6.8 ppb, wanda ya kasance ƙasa da yanke-maki na 25 ppb da aka yi amfani da shi don nuna kumburin asma.

Cutar cututtukan huhu na yau da kullun

FE_NOAn ƙara haɓaka matakan a cikin kwanciyar hankali na COPD, amma yana iya karuwa tare da cututtuka mafi tsanani da kuma lokacin tashin hankali.Masu shan taba na yanzu suna da kusan kashi 70 na ƙananan matakan FeNO.A cikin marasa lafiya tare da COPD, matakan FeNO na iya zama da amfani wajen tabbatar da kasancewar hanawar iska mai juyawa da kuma ƙayyade amsawar glucocorticoid, ko da yake ba a tantance wannan ba a cikin manyan gwaje-gwajen da bazuwar.

Bambancin ciwon asma

FENO yana da matsakaicin daidaiton bincike a cikin tsinkayar ganewar asali na bambance-bambancen ciwon asma (CVA) a cikin marasa lafiya masu fama da tari na yau da kullun.A cikin nazari na yau da kullun na karatun 13 (majinyata na 2019), mafi kyawun kewayon yankewa ga FENO shine 30 zuwa 40 ppb (ko da yake an lura da ƙananan ƙima a cikin binciken biyu), kuma yanki na taƙaitaccen yanki shine 0.87 (95% CI, 0.83-0.89).Ƙayyadaddun ya kasance mafi girma kuma ya fi dacewa fiye da hankali.

Nonasthmatic eosinophilic mashako

A cikin marasa lafiya tare da mashako na eosinophilic marasthmatic (NAEB), sputum eosinophils da FENO suna karuwa a cikin kewayon masu kama da masu ciwon asma.A cikin nazari na yau da kullun na binciken hudu (masu fama da rashin lafiya 390) a cikin marasa lafiya da ke da tari na yau da kullun saboda NAEB, mafi kyawun matakan yankewar FENO sun kasance 22.5 zuwa 31.7 ppb.Ƙididdigar ƙididdiga ta 0.72 (95% CI 0.62-0.80) kuma ƙididdiga ta musamman shine 0.83 (95% CI 0.73-0.90).Don haka, FENO ya fi amfani don tabbatar da NAEB, fiye da cire shi.

Ciwon ciki na sama

A cikin binciken daya na marasa lafiya ba tare da cututtukan huhu ba, cututtukan cututtuka na sama na hoto ya haifar da karuwar FENO.

Hawan jini na huhu

NO yana da kyau a san shi azaman mai shiga tsakani na pathophysiologic a cikin hauhawar jini na huhu (PAH).Bugu da ƙari, vasodilation, NO yana daidaita yaduwar kwayar halitta ta endothelial da angiogenesis, kuma yana kula da lafiyar jiki gaba ɗaya.Abin sha'awa, marasa lafiya tare da PAH suna da ƙananan ƙimar FENO.

FENO yana da alama yana da mahimmancin tsinkaye, tare da ingantaccen rayuwa a cikin marasa lafiya waɗanda ke da haɓaka matakin FENO tare da jiyya (masu hana tashar calcium, epoprostenol, treprostinil) idan aka kwatanta da waɗanda ba su da.Don haka, ƙananan matakan FENO a cikin marasa lafiya tare da PAH da ingantawa tare da hanyoyin kwantar da hankali suna nuna cewa yana iya zama alamar halitta mai ban sha'awa ga wannan cuta.

Rashin aikin ciliary na farko

Nasal NO yana da ƙasa sosai ko ba ya nan a cikin marasa lafiya da rashin aikin ciliary na farko (PCD).Yin amfani da hanci NO don nunawa ga PCD a cikin marasa lafiya tare da tuhuma na asibiti na PCD an tattauna daban.

Wasu sharudda

Baya ga hauhawar jini na huhu, sauran yanayin da ke da alaƙa da ƙananan matakan FENO sun haɗa da hypothermia, da dysplasia bronchopulmonary, da kuma amfani da barasa, taba, maganin kafeyin, da sauran magunguna.