摘要
在人體內呼吸道中，可以偵測到一氧化氮的成分，氣喘病患因呼吸道的發炎反應，使其吐氣中的一氧化氮濃度（ENO），較正常人高出許多。許多研究顯示：氣喘病患經吸入類固醇後，即可降低吐氣一氧化氮濃度。但有關口服類固醇與吐氣一氧化氮濃度的研究，至今仍少見諸於文獻報導。本論文即利用化學發光法測量吐氣中所含一氧化氮濃度，並將測量值和肺功能（FEV1、FEV1/FVC、PEF）作一比較，了解口服類固醇對氣喘病患的影響程度。本次以吐氣受限之線上測量法（On-Line Restricted Exhaled Breath）量測吐氣一氧化氮的濃度，測量六十五位健康個體（對照組）和三十六位經過肺功能証實有氣喘的病患，但尚未經過類固醇治療的病人（病例組）。其中對照組所測得的一氧化氮濃度，平均值為16.87 ±2.21 ppb，病例組所測得的一氧化氮濃度，平均值為33.34 ±18.97 ppb（P＜0.05）， 顯然病例組的吐氣一氧化氮濃度值較對照組高出許多。病例組在經過八週的口服類固醇治療後，吐氣一氧化氮濃度可下降至24 ppb左右，而肺功能不論是FEV1、FVC或PEF 皆有4-6％的增加（P＜0.05），可見口服類固醇對於氣喘疾病的治療具有顯著的功效。 研究指出經過治療後的病患，其吐氣一氧化氮濃度和肺功能仍無法達到正常對照組的水準，但吐氣一氧化氮濃度的下降表示發炎症狀已經改善，肺功能增加表示氣管通透性也已經加強了。因氣喘病患吐氣一氧化氮濃度，高出正常人許多，藉由吐氣一氧化氮濃度的測量再配合肺功能量測，可進一步了解病人的疾病嚴重程度而加以分類，作為醫師用藥治療的依據。（呼吸治療2003;1(1):45～55）
並列摘要
In human respiratory tract, the concentration of exhaled NO (ENO) can be detected. The inflammatory response of asthma patients leads to a higher level of ENO concentration than normal subjects. Some clinical research done on asthmatic patients has demonstrated that after inhaling steroids the concentration of ENO decreases accordingly. Up to date, studies for oral steroids have been very limited. In this thesis, the ENO concentration and the pulmonary function were employed to study the influence of oral steroids on asthma patients. The measurement of ENO concentration is based on the method of On-Line Restricted Exhaled Breath. The 65 healthy subjects (as control group) and 36 asthma subjects detected via pulmonary function test, the mean value of ENO concentration for the control group is 16.87 ±2.21 ppb, 33.34 ±18.97 ppb (p＜0.05) for the asthma subjects . Obviously, the value of the asthma subjects is approximately two times to the control group. After an 8-week treatment of oral steroids, the ENO concentration is down to 24 ppb, and the pulmonary function, including FEV1、FVC、PEF, increases by 4-6% (p＜0.05). It can be concluded that the treatment of asthma with oral steroids leads to significant improvement. In conclusion, the ENO concentration exhaled by asthma patients is much higher than that of normal subjects, the severity of asthma in patients can be categorized by the ENO concentration and pulmonary function as the indicator of treatment. But as per the study, the ENO concentration and pulmonary function post treatment still cannot achieve the regular standard of the healthy subjects as the control group. In fact, the decrease of ENO concentration indicates improvement of the inflammation syndrome, and the good performance of pulmonary function implies that permeability of the trachea has been increased.