Ngakhale kuti mphumu yaikulu imakhala yotupa, odwala omwe ali ndi ziphuphu amachokera ku zifukwa zina zotupa (monga basophils , lymphocytes , kapena neutrophils ) sangathe kupindula ndi kuyesedwa kwa FeNO. Malinga ndi Guide ya Clinical Practice Guideline yochokera ku American Thoracic Society, FeNO angagwiritsidwe ntchito kuti apeze matenda opatsirana ndi kutupiritsa matenda a chifuwa cha mphumu ngati pali umboni wofunikira.
Momwemonso, mapepala apamwamba a FeNO amasonyeza kutupa m'mapapu komanso kuti wodwalayo akhoza kuyankha ma steroid odziteteza ochotsera kafukufuku wammbuyo. Choncho, FeNO amadziwitsa bwino momwe angayankhire mankhwala m'malo mofufuza matenda a mphumu.
Mavuto ndi Kuwunika Kwambiri
Mapulani ambiri a mphumu panopa akuyendetsedwa ndi zizindikiro za mphumu kapena chiwerengero cha mphukira. Zizindikiro zamtundu monga kuphulika , chifuwa , chifuwa , ndi kupuma pang'ono kungakhale kosavuta ndipo sizikugwirizana ndi kuchuluka kwa kutupa kumene kulipo m'mapapu anu. Kuthamanga kwa nsomba kungakhale kofanana kokha ndi mlingo wa kutupa kwa ndege monga mwa kafukufuku wina.
Malangizo a FeNO Kuwunika Kuthandizira Khunyu
Pafupifupi hafu ya zochitika zonse za mphumu zimaphatikizapo kutupa kwa mpweya wabwino. Kutupa kotereku kumabwera chifukwa cha kukwera kwa maselo ndi maselo ena omwe amachititsa makamaka mchere wa nitric.
Monga tafotokozera kale, odwala omwe ali ndi kutupa kwa eosinophilic adakweza mpikisano wa FeNO, pamene odwala okhala ndi zifukwa zina samapanga mpata wa FeNO. Kuonjezera apo, kafukufuku wasonyeza kutupa kwachidziwitso kwa odwala omwe ali ndi miyeso yapamwamba ya FeNO. Chotsatira chake, miyeso yapamwamba ya FeNO ikuganiziridwa kuti imadziwika kuti odwala omwe angathe kuchitapo kanthu pa mankhwala ndi steroid asonyeza kuti miyeso yapamwamba ya FeNO ndiyomwe ikuyankhira bwino.
Makhalidwe a FeNO
Maseŵero a FeNO ayesedwa mu maofesi a udokotala. Odwala amatha kupuma bwinobwino ndiyeno amatha kupuma kudzera mu fyuluta yosayera. Miyeso ya FeNO ndiyomwe ikupezeka maminiti pang'ono kuti mutanthauzire ndi dokotala wanu.
Zigawo zachizoloŵezi, zamkati, ndi zapamwamba zimaperekedwa mu tebulo ili m'munsiyi.
| Akuluakulu | Ana | |
|---|---|---|
| 12 ndi zakale | 4-12 | |
| Low | <25 | <20 |
| Okhazikika | ≥ 25- ≤ 50 | ≥ 20- ≤ 35 |
| Pamwamba | > 50 | > 35 |
| ppb = gawo pa biliyoni | ||
FeNO Gwiritsani Ntchito Chisamaliro cha Phumu
Optimum Patient Care Research Data ndi United Kingdom yofufuzira ma database omwe alibe mbiri, zotsatira za nthawi yaitali odwala odwala mphumu ku UK. Mndandanda wa mndandandawo unayesedwa kuti awone odwala omwe samalandira mankhwala otsekemera a steroid koma akhoza kupindula ndi odwala amene akugwiritsidwa ntchito pogwiritsa ntchito mankhwala monga FeNO monga chizindikiro.
Ofufuza anapeza kuti angapo madokotala oyamba kusamalira mphumu pogwiritsa ntchito FeNO. Chochititsa chidwi, kugwiritsa ntchito kafukufuku wa FeNO kumagwirizanitsidwa ndi kuwonjezereka kolimbikira kuchipatala chowonjezera pa ntchito yake kuyambitsa mankhwala osakaniza otchedwa steroid kapena chizindikiro cha mankhwala opititsa patsogolo. Kuwonjezera apo, kafukufuku wina wasonyeza kuti kuchuluka kwa matenda a mphumu kukhala ochepa kwa odwala pogwiritsa ntchito FeNO monga gawo la njira yawo yowunika.
Kafukufuku wochokera ku US ku malo opumphura 10 a mphumu anapeza kuti FeNO imagwiritsa ntchito mankhwala owonjezera opatsirana pogwiritsira ntchito steroids poyerekeza ndi kayendetsedwe ka kafukufuku wogwiritsa ntchito malangizo okhudza mphumu, koma amapereka kusintha kwakukulu kwa zizindikiro za mphumu zomwe zinali zofunika kwambiri.
> Zotsatira:
> Bateman ED, Boushey HA, Bousquet J. Kodi njira yotsogoleredwa yotchedwa asthma Control iyenera kupindula? Kupeza mphumu yabwino > controL > kuphunzira. Am J Respir Crit Care Med 2004, 170: 36-844.
> Dwelk RA, Boggs PB, Erzurum SC ndi al. Momwe Mungaphunzitsire ATS Clinic Practice Guideline: Kutanthauzira kwa Mitsempha ya Oxyde Oxide (FENO) ya Clinic Applications.
> Global Initiative for Asthma: Mchitidwe wapadziko lonse wa kasamalidwe ka khunyu ndi kupewa. 2012.
> Haldar P, Pavord ID, Shaw DE, Berry MA, Thomas M, Brightling CE, Wardlaw AJ, Green RH. Kusanthula kwa Cluster ndi matenda a asthma phenotypes. Am J Respir Crit Care Med 2008, 178: 218-224.
> Langley SJ, Goldthorpe S, Custovic A, Woodcock A. Chiyanjano pakati pa mapiritsi, ntchito yowonongeka, komanso kutulutsa mpweya wa nitric m'gulu lalikulu la odwala asthmatic.
> National Heart, Lung, ndi Blood Institute. Report of Panel Panel 3 (EPR3): Malangizo Othandizira Kuzindikira ndi Kusamalira Khunyu.
> NHLBI / WHO WHO Workshop Report: Njira zamakono zothandizira kuti azitsatira ndi kupewa. Bethesda, MD. National Institutes of Health. National Heart, Lung, ndi Blood Institute; 1995. Kufalitsidwa No. 95-3659.