Nakuba amaphesenti amakhulu e-asthma ngenxa yokuvuvukala kwe-eosinophilic, iziguli ezinezimpawu ze-asthma ezibangelwa ezinye izimbangela zokuvuvukala (isib. Ama- basophils , i- lymphocytes , noma i- neutrophils ) ngeke zizuze ekuhlolweni kwe-FeNO. Ngokomhlahlandlela wezokwelapha we-Clinical Practice kusukela ku-American Thoracic Society, i-FeNO ingasetshenziselwa ukuxilongwa kokuvuvukala kwe-eosinophilic nokuxhaswa kwesifo se-asthma uma kudingwa ubufakazi obuningi.
Ngokuqondile, amazinga aphakanyisiwe we-FeNO abonisa ukuthi ukuvuvukala emaphashini nokuthi isiguli kungenzeka siphendule kuma- steroids angatholakali esekelwe ucwaningo olwedlule. Ngakho-ke, i-FeNO iveza ngokunembile impendulo engaba khona ekwelashweni kunokwenza ukuxilongwa okuqondile kwe-asthma.
Izinkinga Ngokuqapha Kwendabuko
Amapulani amaningi okusebenza nge-asthma okwamanje aqhutshwa yizimpawu zesifo se-asthma noma i-peak flows. Izimpawu zendabuko ezinjenge- wheezing , ukuqina kwesifuba , ukukhwehlela nokuphefumula kungabi kakhulu futhi akuhlobene neze nokuvuvukala okukhona emaphashini akho. Ukugeleza kwe-Peak kungahle kuhlotshaniswe ngokuncane nezinga lokuvuvukala kwamanzi ngokusho komunye ucwaningo.
Izinzuzo ze-FeNO zokuqapha i-Asthma
Cishe isigamu sazo zonke izimo ze-asthma zihlanganisa i-eosinophilic ukuvuvukala kwamanzi. Lolu hlobo lokuvuvukala luvela ekuphakameni kwamaseli amancane namanye amaseli okwandisa ngokukhethekile amazinga we-nitric oxide.
Njengoba kushiwo ngaphambili, iziguli ezinokuvuvukala kwe-eosinophilic ziye zaphakamisa amazinga we-FeNO, kanti iziguli ezinokuvuvukala kwezinye izimbangela azizange ziphakanyise amazinga we-FeNO. Ngaphezu kwalokho, ucwaningo luye lwabonisa ukuvuvukala okuqinisekisiwe kwe-biopsy kuziguli ezinezinga eliphezulu le-FeNO. Ngenxa yalokho, amazinga e-FeNO aphakanyisiwe acatshangwa ukukhomba iziguli ezingase ziphendule ukwelashwa kwe-steroid nezifundo zibonise ukuthi amazinga we-FeNO aphakanyisiwe ayingxenye yokwenza impendulo enhle.
Amazinga we-FeNO
Amazinga e-FeNO njengamanje alinganiselwa kumahhovisi odokotela. Iziguli zidlulisa ngokuphelele bese zithatha umoya ovamile ngaphakathi kwesihlungi esilahlayo. Amazinga we-FeNO atholakalayo emaminithini ambalwa ukuze ahumushe udokotela wakho.
Amazinga avamile, aphakathi nendawo aphakanyisiwe asethwe etafuleni elingezansi.
| Abantu abadala | Izingane | |
|---|---|---|
| 12 nangaphezulu | 4-12 | |
| Okuphansi | <25 | <20 |
| Okuphakathi | ≥ 25- ≤ 50 | ≥ 20- ≤ 35 |
| Phezulu | > 50 | > 35 |
| ppb = izingxenye eziyizigidi eziyizinkulungwane | ||
I-FeNO isebenze ekunakekelweni kwe-Asthma
I-Optimum Care Patient Research Data Idatha ye-United Kingdom yokuphefumula equkethe idatha engaziwa, yesikhathi eside semiphumela yeziguli ze-asthma e-UK. I-database ihlolwe ukukhomba iziguli ezingatholi ukwelashwa kwe-steroid engatholakali kodwa zingase zizuze kanye neziguli ezaziphathwa ngokwemithi ngokusebenzisa i-FeNO njengemakaki.
Abaphenyi bathola ukuthi izinombolo ezincane zokunakekelwa okuyinhloko odokotela abaphatha isifo sofuba ngokusebenzisa i-FeNO. Ngokuthakazelisayo, ukusebenzisa ukuhlola kwe-FeNO kuhlotshaniswa nokunamathela kokwandiswa komuthi wokwelashwa ngaphezu kokusetshenziswa kwayo ukuqala ukwelashwa kwe-steroid engalutholakali noma inkomba ye-therapy-up-up. Ukwengeza, olunye ucwaningo luye lwabonisa ukuthi izinga lokukhubazeka kwe-asthma liba ngaphansi kweziguli zisebenzisa i-FeNO njengengxenye yesasu labo lokuqapha.
Ukutadisha okusekelwe e-US ezikhungweni ze-asthma ezi-10 bathola ukuthi ukusetshenziswa kwe-FeNO kwaholela ekudleni okuphezulu kwe-steroids engatholakali uma kuqhathaniswa nokuphathwa okujwayelekile okusekelwe emihlahlandlela ye-asthma, kodwa kwanikeza ukuthuthukiswa okuphawulekayo embonisweni ye-asthma eyayibalulekile emtholampilo.
> Imithombo:
> Bateman ED, uBoushey HA, uBousquet J. Ingabe ukulawulwa kwe-asthma eqondiswayo okuqondiswayo Kungenziwa? Ukuthola i-asthma efanele > controL > ukutadisha. Am J Respir Crit Care Med 2004, 170: 36-844.
> Dwelk RA, Boggs PB, Erzurum SC et al. I-ATS Yomhlahlandlela Wokusebenza Ngokwemtholampilo Ye-ATS: Ukuchazwa kwamazinga e-Oxyde Nitric (Extension Levels Oxyde Levels).
> I-Global Initiative ye-Asthma: Isu lomhlaba jikelele lokuphathwa kwe-asthma nokuvimbela. 2012.
> Haldar P, IDP Pavord, Shaw DE, Berry MA, Thomas M, CE, Bardling CE, Wardlaw AJ, Green RH. Ukuhlaziywa kweCluster kanye nama-phenotypes e-clinical asthma. Am J Respir Crit Care Med 2008, 178: 218-224.
> Langley SJ, i-Goldthorpe S, i-Custovic A, i-Woodcock A. Ukusebenzisana phakathi komsebenzi wamapulmonary, reactivity ye-bronchial, kanye ne-nitric oxide exhaled inqwaba yeziguli ze-asthmatic.I-Anergyergy Asthma Immunol2003, 91: 398-404.
> Inhliziyo kaZwelonke, iLung, ne-Blood Institute. Umbiko wePhaneli Wabachwepheshe 3 (EPR3): Izinkombandlela Zokuthola Ukuhlolwa Nokuphathwa Kwe-Asthma.
> Umbiko we-NHLBI / WHO Workshop: Isu lomhlaba jikelele lokuphathwa kwe-asthma nokuvimbela. Bethesda, MD. Izikhungo zezempilo zikazwelonke. I-National Heart, Lung, ne-Blood Institute; 1995. Ukushicilelwa No. 95-3659.