TE WHAKAMAHINGA HAUORA O TE FENO I TE MATE HUA

Te whakamaoritanga o te NO i whakapūhaina i roto i te mate huango

Kua whakaarohia tētahi tikanga māmā ake i roto i te American Thoracic Society Clinical Practice Guideline mō te whakamārama i te FeNO:

• Ko te iti iho o te FeNO i te 25 ppb i roto i ngā pakeke, me te iti iho i te 20 ppb i roto i ngā tamariki kei raro iho i te 12 tau te pakeke, e tohu ana i te korenga o te mumura ara manawa eosinophilic.
• Ko te nui ake o te FeNO i te 50 ppb i roto i ngā pakeke, i te 35 ppb rānei i roto i ngā tamariki, e tohu ana tēnei i te mumura o te ara manawa eosinophilic.
• Me āta whakamārama ngā uara o te FeNO i waenga i te 25 me te 50 ppb i roto i ngā pakeke (20 ki te 35 ppb i roto i ngā tamariki) me te aro ki te āhuatanga haumanu.
• Ko te pikinga o te FeNO me te huringa neke atu i te 20 ōrau, me te neke atu i te 25 ppb (20 ppb i roto i ngā tamariki) mai i tētahi taumata pumau i mua, e tohu ana i te pikinga o te mumura ara manawa eosinophilic, engari he whānui ngā rerekētanga i waenga i ngā tāngata takitahi.
• He mea nui pea te hekenga o te FeNO neke atu i te 20 ōrau mō ngā uara neke atu i te 50 ppb, neke atu rānei i te 10 ppb mō ngā uara iti iho i te 50 ppb.

Te tautuhi me te tautuhi i te mate huango

E kī ana te Global Initiative for Asthma kia kaua e whakamahia te FeNO hei tātaritanga i te mate huango, nā te mea kāore pea e piki ake i roto i te mate huango noneosinophilic, engari ka piki ake pea i roto i ngā mate ehara i te mate huango, pērā i te bronchitis eosinophilic, te rhinitis mate pāwera rānei.

Hei aratohu ki te rongoā

E kī ana ngā aratohu o te ao kia whakamahia ngā taumata FeNO, hei tāpiri atu ki ētahi atu aromatawai (hei tauira, te tiaki haumanu, ngā pātai) hei ārahi i te tīmatanga me te whakarerekētanga o te rongoā whakahaere huango.

Te whakamahinga i roto i te rangahau haumanu

He mea nui te mahi a te hauota hauota i roto i ngā rangahau haumanu, ā, tera pea ka āwhina i te whakawhānui ake i tō tātou māramatanga ki te mate huango, pērā i ngā āhuatanga e whai pānga ana ki te kaha haere o te mate huango me ngā wāhi me ngā tikanga mahi a ngā rongoā mō te mate huango.

TE WHAKAMAHI I NGĀ MATE MANAWA KEI ATU

Te mate pūkahukahu me te mate pukupuku kiriuhi

He iti ake ngā taumata FeNO o ngā tamariki he cystic fibrosis (CF) i ngā mana whakahaere e tika ana. He rerekē, i kitea i roto i tētahi rangahau he teitei ake ngā taumata FeNO o ngā tūroro he bronchiectasis kore-CF, ā, i honoa ēnei taumata ki te nui o te rerekētanga e kitea ana i runga i te CT uma.

Te mate pūkahukahu interstitial me te sarcoidosis

I roto i tētahi rangahau o ngā tūroro e pāngia ana e te scleroderma, i kitea he nui ake te NO i whakapūhaina i roto i ngā tūroro e pāngia ana e te mate pūkahukahu interstitial (ILD) ki te whakataurite ki te hunga kāore he ILD, engari i kitea te rerekētanga i roto i tētahi atu rangahau. I roto i tētahi rangahau o ngā tūroro 52 e pāngia ana e te sarcoidosis, ko te uara FeNO toharite he 6.8 ppb, he iti iho i te tohu tapahi o te 25 ppb i whakamahia hei tohu i te mumura o te huango.

Te mate pūkahukahu ārai mau tonu

FE_NOHe iti noa te pikinga o ngā taumata i roto i te COPD pumau, engari ka piki ake pea me te mate kino ake me te wā e kaha haere ana. Tata ki te 70 ōrau te iti iho o ngā taumata FeNO o ngā kaipaipa o nāianei. I roto i ngā tūroro e pāngia ana e te COPD, tera pea he whai hua ngā taumata FeNO ki te whakatau i te aroaro o te aukati rere o te hau ka taea te whakahuri me te whakatau i te uruparenga glucocorticoid, ahakoa kāore anō kia aromatawaihia tēnei i roto i ngā whakamātautau matapōkere nui.

Te momo mate huango mare

He tika te tātaritanga o te FENO ki te matapae i te tātaritanga o te mate huango momo mare (CVA) i roto i ngā tūroro e maremare mau tonu ana. I roto i tētahi arotake pūnaha o ngā rangahau 13 (ngā tūroro 2019), ko te awhe tapahi pai rawa atu mō te FENO he 30 ki te 40 ppb (ahakoa i kitea ngā uara iti iho i roto i ngā rangahau e rua), ā, ko te horahanga whakarāpopototanga i raro i te pihi he 0.87 (95% CI, 0.83-0.89). He teitei ake, he ōrite ake te motuhaketanga i te aro.

Te mate pūkahukahu eosinophilic kāore i te huango

I roto i ngā tūroro e pangia ana e te mate pūkahukahu eosinophilic nonasthmatic (NAEB), ka piki ake ngā eosinophil sputum me te FENO i roto i te awhe rite ki ngā tūroro e pangia ana e te mate huango. I roto i tētahi arotake pūnaha o ngā rangahau e whā (390 tūroro) i roto i ngā tūroro e maremare mau tonu ana nā te NAEB, ko ngā taumata tapahi FENO tino pai ko te 22.5 ki te 31.7 ppb. Ko te aro nui i whakatauhia ko te 0.72 (95% CI 0.62-0.80) ā, ko te motuhake i whakatauhia ko te 0.83 (95% CI 0.73-0.90). Nō reira, he pai ake te FENO ki te whakaū i te NAEB, i te whakakore.

Ngā mate urutā o runga

I roto i tētahi rangahau o ngā tūroro kāore he mate pūkahukahu, i hua ake te pikinga o te FENO i ngā mate urutā o te manawa o runga.

Te toto toto tiketike o te pūkahukahu

E mōhiotia whānuitia ana te NO hei takawaenga pathophysiological i roto i te toto toto tiketike pūkahukahu (PAH). Haunga te whakanui i te toto, ka whakahaere te NO i te tipu o ngā pūtau endothelial me te angiogenesis, ā, ka pupuri i te hauora whānui o ngā toto toto. He mea whakamīharo, he iti ngā uara FENO o ngā tūroro whai PAH.

Te āhua nei he hiranga anō hoki tō te FENO ki te matapae, me te pikinga ake o te oranga o ngā tūroro kua piki ake te taumata FENO me te rongoā (ngā aukati hongere konupūmā, epoprostenol, treprostinil) ki te whakaritea ki te hunga kāore. Nō reira, ko te iti o ngā taumata FENO i roto i ngā tūroro me te PAH me te whakapainga me ngā rongoā whai hua e kī ana he tohu pai pea tēnei mō tēnei mate.

Te ngoikore o te kiriuhi tuatahi

He tino iti, he ngaro rānei te NO ihu i roto i ngā tūroro e pāngia ana e te ngoikore o te kiriuhi tuatahi (PCD). Ka matapakihia motuhaketia te whakamahinga o te NO ihu hei tirotiro mō te PCD i roto i ngā tūroro e whakapaetia ana he PCD.

Ētahi atu āhuatanga

Haunga te toto toto tiketike o te pūkahukahu, ko ētahi atu āhuatanga e pā ana ki ngā taumata FENO iti ko te hypothermia, me te bronchopulmonary dysplasia, tae atu ki te whakamahinga o te waipiro, te tupeka, te kawheine, me ētahi atu raau taero.