Patrones inflamatorios en niños asmáticos basados en la determinación de óxido nítrico alveolar / Inflammatory Patterns in Asthmatic Children Based on Alveolar Nitric Oxide Determination
Arch. bronconeumol. (Ed. impr.)
; 51(6): 279-284, jun. 2015. tab, graf
Article
em Es
| IBECS
| ID: ibc-139507
Biblioteca responsável:
ES1.1
Localização: BNCS
RESUMEN
Introducción: El óxido nítrico (NO) puede medirse a nivel proximal (flujo máximo NO en vía aérea [J'awNO]) y distal (concentración alveolar de NO [CANO]). Se han descrito 4 patrones inflamatorios en asmáticos, aunque su relevancia no ha sido bien establecida. El objetivo ha sido determinar el J'awNO y la CANO para establecer 4 categorías inflamatorias en asmáticos. Material y métodos: Estudio transversal de una muestra de niños sanos y asmáticos. Determinación de NO exhalado a flujos múltiples. De acuerdo con el modelo bicompartimental se obtuvieron la CANOy el J'awNO. En asmáticos se realizó cuestionario de control de asma (CAN) y espirometría forzada. Categorización de pacientes en tipo i (J'awNO y CANO normal), tipo ii (J'awNO elevado y CANO normal), tipo iii (J'awNO y CANO elevados) y tipo iv (J'awNO normal y CANO elevado). Estudio de correlación entre FENO,50, J'awNO y CANO mediante R de Spearman. Análisis de la varianza y comparaciones pareadas, mediante corrección post hoc de Bonferroni. Resultados: Se estudiaron 162 niños: 49 (32,23%) controles sanos y 103 (67,76%) asmáticos. Se excluyeron 10 niños, 4 (2.4%) porque las eterminaciones fueron incorrectas y 6 (3,7%) porque las determinaciones no siguieron el modelo lineal (valores de CANO negativos). En controles la FENO,50 (ppb) (mediana y rango) fue 11,5 (1,6-27,3), J'awNO (pl/s) 516 (98,3-1.470) y CANO(ppb) 2,2 (0,1-4,5). De los asmáticos, 44 (42,7%) se categorizaron en tipo i, 41 (39,8%) en tipo ii, 14 (13,5%%) en tipo iii y 4 (3,88%) en tipo iv. Buena correlación entre J'awNO y FENO,50(r = 0,97). No hubo asociación entre J'awNO y CANO. Disminución significativa de FEV1/FVC en tipo iii (media 79,8 ± 7,5). La morbilidad fue significativamente superior en tipos iii y iv. Conclusiones: Los valores de normalidad obtenidos son similares a los previamente publicados. Los asmáticos con CANO elevado presentaron mayor morbilidad. No hay correlación entre inflamación proximal y distal
ABSTRACT
Introduction: Nitric oxide (NO) levels can be measured at proximal (maximum airway NO flux [JawNO]) and distal (alveolar NO concentration [CANO]) levels. Four inflammatory patterns have been described in asthmatic individuals, although their relevance has not been well established. The objective was to determine JawNO and CANO in order to establish four inflammatory categories in asthmatics. Material and methods: Cross-sectional study of a sample consisting of healthy and asthmatic children. Exhaled NO was determined at multiple flows. JawNO and CANO were obtained according to the two-compartment model. The asthma control questionnaire (ACQ) and spirometry were administered to asthmatic children. Patients were categorized as type i (normal JawNO and CANO), type ii (elevated JawNO and normal CANO), type iii (elevated JawNO and CANO) and type iv (normal JawNO and elevated CANO). Correlation between FENO,50, JawNO and CANO was analyzed using Spearmans R Correlation Test. Analysis of variance and paired comparisons were performed using the Bonferroni correction. Results: One hundred sixty-two children were studied, of whom 49 (32.23%) were healthy controls and 103 (67.76%) asthmatics. In the control subjects, FENO,50 (ppb)(median and range) was 11.5 (1.6 to 27.3), JawNO (pl/s) was 516 (98.3 to 1470) and CANO (ppb) was 2.2 (0.1 to 4.5). Forty-four (42.7%) of the asthmatic participants were categorized as type i, 41 (39.8%) as type ii, 14 (13.5%) as type iii and 4 (3.88%) as type iv. Good correlation was observed between JawNO and FENO,50 (r = 0.97). There was no association between JawNO and CANO. FEV1/FVC decreased significantly in type iii (mean 79.8 ± 7.5). Morbidity was significantly higher in types iii and iv. Conclusions: Normal values obtained are similar to those previously reported. Asthmatics with high CANO showed higher morbidity. No correlation was found between proximal and distal inflammation
Texto completo:
1
Base de dados:
IBECS
Assunto principal:
Asma
/
Espirometria
/
Preparações Farmacêuticas
/
Óxido Nítrico
Tipo de estudo:
Evaluation_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child
/
Humans
Idioma:
Es
Ano de publicação:
2015
Tipo de documento:
Article