慢性阻塞性肺疾病與吸煙者吐氣一氧化氮之變化

Exhaled Nitric Oxide Levels in Smokers with Chronic Obstructive Pulmonary Disease

蘇千玲(Chien-Ling Su) ； 吳清平(Chin-Pyng Wu)

《呼吸治療》 1卷1期 (2002/01) Pp. 23-28

https://doi.org/10.6269/JRT.2002.1.1.04

摘要

慢性阻塞性肺疾病（chronic obstructive pulmonary disease, COPD），主要是因慢性支氣管炎或肺氣腫所引起氣道阻塞情形，而抽煙是主要因素之一。吸煙患者吐氣一氧化氮（nitric oxide, NO）偏低，目前原因尚不清楚，也許是因吸煙者使呼吸道上皮受損而影響誘發脢（inducible NOS, iNOS）的活性，導致內生性一氧化氮（endogenous NO）生成降低，而增加呼吸道感染的機會，COPD患者多為吸煙者，穩定COPD患者內生性NO會減少，而不穩定或嚴重COPD患者，痰液中性球增加與氣道阻塞程度成正比的增加，而刺激NO生成。因此穩定的COPD患者，第一秒吐氣量(FEV1)與吐氣NO呈正相關，而不穩定或嚴重COPD患者，FEV1與內生性NO呈負相關。監測吐氣NO，可為COPD後續發展及病情預後的重要指標。（呼吸治療2002;1(1):23～28）

關鍵字

慢性阻塞性肺疾病 ； 一氧化氮 ； 誘發脢

並列摘要

Chronic obstructive pulmonary disease (COPD), in defined as a disease state characterized by the presence of air flow obstruction due to chronic bronchitis or emphysema, the main risk factor is smoking.
The mechanism by which cigarette smoking reduce exhaled NO is not certain, because NO itself appears to reduce the activity of iNOS (indicuble NOS), may downregulate the enzyme in cells of the respiratory tract, resulting in a reduction of exhaled NO, Increase the risk of respiratory infections.
Most of COPD patients are chronic smoker. In those chronic stable COPD patients, the level of endogenous NO deceased as FEV1 deteriorated. In those unstable or severe type of COPD patients , the sputum neutrophil increased as the airway obstruction got worse, which might induce endogenous NO production .Therefore the NO level was negatively relative to FEV1.

並列關鍵字

Chronic Obstrictive Pulmonary Disease ； Nitric Oxide ； Inducible NOS