Mō ngā tau maha, kua noho te whakamātautau Fractional Exhaled Nitric Oxide (FeNO) hei hoa whai hua i roto i te kete taputapu a te tākuta mate huango, hei ārahi i ngā whakataunga whakahaere. Ko te whakahoutanga o te tau 2025 ki ngā aratohu Global Initiative for Asthma (GINA) he tohu i tētahi whanaketanga nui, e whakawhānui ana i te tūranga o te FeNO ki tua atu i te aromatawai me te whakahaere hei tautoko kaha i te tautuhi i te mate huango mumura Momo 2 (T2). E whakaae ana tēnei whakatikatika i te tūranga matua o te phenotyping i roto i te tiaki mate huango hou, ā, e whakarato ana i tētahi huarahi tika ake, e ahu mai ana i te koiora ki te tautuhi tuatahi.
FeNO: He Matapihi ki te Mumura o te Ara Rererangi
Ka ine te FeNO i te kukū o te hauota hauota i roto i te manawa e tukuna ana, e mahi ana hei tohu tika, kore-whakaekenga mō te mumura ara manawa eosinophilic, T2 rānei. Ko tēnei mumura, e akiakihia ana e ngā cytokines pēnei i te interleukin-4, -5, me te -13, e tohuhia ana e te IgE teitei ake, ngā eosinophils i roto i te toto me te huware, me te urupare ki ngā corticosteroids. I ngā wā o mua, kua whakamahia te FeNO ki:
Matapae i te urupare ki ngā corticosteroids manawa (ICS): Ko ngā taumata FeNO teitei e tohu pono ana i te tūponotanga nui ake o te whai hua mai i te rongoā ICS.
Aroturuki i te piripono me te whakahaere mumura: Ka taea e ngā inenga raupapa te aromatawai i te piripono o te tūroro ki te rongoā ārai-mumura me te pehi i te mumura T2 kei raro.
Arataki i te whakarerekētanga maimoatanga: Ka taea e ngā au o te FeNO te āwhina i ngā whakatau mō te whakanui ake, te whakaiti rānei i te horopeta ICS.
Te Huringa 2025: FeNO i te Ara Tātaritanga
Ko te whanaketanga matua o te pūrongo GINA o te tau 2025 ko te tautoko kaha ake i te FeNO hei āwhina tātaritanga mō te tautuhi i te mate huango T2-teitei i te wā e puta ai. He mea tino nui tēnei i roto i te horopaki o ngā whakaaturanga mate huango rerekē.
Te Wehewehe i ngā Āhuatanga o te Hua Manu: Ehara i te mea ko te wheezing, te kore manawa katoa he hua manu T2 noa iho. Tērā pea ka puta mai ngā tohu rite i roto i ngā tūroro he mumura kore-T2, he mumura pauci-granulocytic rānei, engari he iti ngā taumata FeNO. Ko te taumata FeNO e piki haere tonu ana (hei tauira, >35-40 ppb i roto i ngā pakeke) i roto i te tūroro he tohu whakaaro (mare, wheezing, herenga rere o te hau) he taunakitanga pai mō te endotype T2-teitei, ahakoa i mua i te whakamātautau maimoatanga.
Te Tautoko i te Tātaritanga i roto i ngā Horopaki Wero: Mō ngā tūroro he tohu rerekē, he koretake rānei ngā hua o te spirometry, he noa rānei i te wā e whakamātautauhia ana, ko te FeNO teitei ake pea te taunakitanga tino nui e tohu ana i tētahi tukanga mumura T2 kei raro. Ka āwhina i te neke i te tātaritanga mai i tētahi e ahu mai ana i ngā tohu rerekē ki tētahi e whai tohu koiora ana.
Te Whakamōhio i te Rautaki Maimoatanga Tuatahi: Mā te whakauru i te FeNO i te wāhanga tātaritanga, ka taea e ngā tākuta te wehewehe i te maimoatanga i runga i te whakaaro nui mai i te tīmatanga. Ehara i te mea ko te taumata FeNO teitei anake te tautoko i te tātaritanga huango engari ka tohu kaha hoki i te urupare pai ki te maimoatanga ICS raina tuatahi. Mā tēnei ka āwhina i tētahi huarahi maimoatanga whaiaro ake, "tika-wā-tuatahi", ka whakapai ake pea i te mana whakahaere me ngā putanga wawe.
Ngā Pānga Hauora me te Whakaurunga
E taunaki ana ngā aratohu o te tau 2025 kia whakauruhia te whakamātautau FeNO ki roto i ngā mahi tātaritanga tuatahi ina kitea he whakapae mō te mate huango, ā, kei te wātea te urunga ki te whakamātautau. E whai ana te whakamaoritanga i tētahi tauira papatipu:
Te FeNO teitei (>50 ppb i roto i ngā pakeke): E tautoko ana i te tautuhi i te mate huango T2-teitei, ā, e tohu ana i te uruparenga ICS.
FeNO Waenga (25-50 ppb i roto i ngā pakeke): Me whakamārama i roto i te horopaki haumanu; tera pea e tohu ana i te mumura T2 engari ka pāngia pea e te atopy, te pānga o ngā mate pāwera tata nei, me ētahi atu āhuatanga rānei.
FeNO iti (<25 ppb i roto i ngā pakeke): Ka whakaiti i te tūponotanga o te mumura T2-tiketike, ka whakaarohia he tātaritanga kē atu (hei tauira, te ngoikore o te taura reo, ngā momo huango ehara i te T2, COPD) me ngā take kore-mumura o ngā tohu.
Kāore tēnei whakahoutanga e hanga i te FeNO hei whakamātautau tātaritanga takitahi engari e whakanoho ana hei tāpiri kaha ki te hītori haumanu, ngā tauira tohu, me te whakamātautau spirometry/whakahoki. Ka tāpirihia he paparanga o te kore whakaaro e whakapai ake ana i te maia ki te tātaritanga.
Whakamutunga
Ko ngā aratohu GINA o te tau 2025 e tohu ana i tētahi panonitanga tauira, e whakaū ana i te mana o te whakamātautau FeNO mai i te tāpiri whakahaere ki te tautoko tātaritanga whakauru mō te mate huango Momo 2. Mā te whakarato i tētahi inenga tonu, whai take mō te mumura T2 taketake, ka whakamanahia e te FeNO ngā tākuta ki te hanga i ngā tātaritanga phenotypic tika ake i te tūtakitanga tuatahi. Ka hua ake tēnei ki te maimoatanga tuatahi e whai kiko ana, e whai hua ana hoki, e hangai pai ana ki te wawata hou o te rongoā tika i roto i te tiaki huango. I te whānui haere o te urunga atu ki te hangarau FeNO, ko tana mahi ki te tātaritanga me te whakahaere i te rongoā mō te mate huango T2-teitei ka waiho hei paerewa tiaki, ā, ko te whāinga whakamutunga kia pai ake ngā putanga tūroro mā te wawaotanga wawe me te tika ake.
Ko te Pūnaha Tātari Hau Manawa UBREATH (BA200) he taputapu hauora i hangaia, i hangaia hoki e e-LinkCare Meditech kia honoa ki te whakamātautau FeNO me te FeCO hei whakarato i te ine tere, tika, me te tau hei āwhina i te tautuhi me te whakahaere haumanu pēnei i te mate huango me ētahi atu mumura ara manawa mau tonu.
Wā tuku: Hanuere-23-2026