Kwemakore, bvunzo yeFractional Exhaled Nitric Oxide (FeNO) yakashanda seshamwari inokosha muchirongwa chekurapa chirwere cheasthma, ichitungamira zvikuru sarudzo dzekutarisira. Kuvandudzwa kwa2025 kweGlobal Initiative for Asthma (GINA) gwara kunoratidza shanduko huru, zvichiwedzera zviri pamutemo basa reFeNO kupfuura kuongororwa uye manejimendi kuti ikozvino ritsigire kuongororwa kweType 2 (T2) inflammatory asthma. Kuvandudzwa uku kunobvuma basa guru re phenotyping mukutarisira kweasthma yemazuva ano uye kunopa nzira chaiyo, yakavakirwa pabhayoloji yekuongorora kwekutanga.
FeNO: Hwindo muKuputika kweAirway
FeNO inoyera huwandu hwe nitric oxide mumhepo inobuda, iyo inoshanda sechiratidzo chakananga, chisingapindi muropa che eosinophilic, kana T2, kuzvimba kwemhepo. Kuzvimba uku, kunokonzerwa nema cytokines akadai se interleukin-4, -5, uye -13, kunoratidzwa neIgE yakakwira, eosinophils muropa ne sputum, uye kupindura ku corticosteroids. Kazhinji, FeNO yaishandiswa ku:
Fanotaurai kuti mushonga we corticosteroids unofemedzwa (ICS) ungapindura sei: Mazinga eFeNO akakwira anoratidza kuti mushonga weICS unogona kubatsira zvakanyanya.
Tarisa kutevedzera uye kudzora kuzvimba: Kuyera kwezvikamu kunogona kuongorora murwere achitevedzera kurapwa kunoderedza kuzvimba uye kudziviswa kwekuzvimba kweT2 kuri pasi.
Gadzirisai nzira dzekurapa: Mafambiro eFeNO anogona kubatsira pakusarudza kuwedzera kana kuderedza mushonga weICS.
Kuchinja kwa2025: FeNO muNzira yeKuongorora
Kufambira mberi kukuru mumushumo weGINA wegore ra2025 kusimbiswa kwakasimba kweFeNO senzira yekubatsira pakuongorora chirwere cheasthma cheT2-high panguva yekuratidzwa kwacho. Izvi zvakakosha zvikuru kana tichitarisa zviratidzo zveasthma zvakasiyana-siyana.
Kusiyanisa Mafungiro eAsthma: Haasi ese mafemo kana kushaya mweya zviri zve classic T2 asthma. Varwere vane kuzvimba kusiri kweT2 kana pauci-granulocytic vanogona kuratidza zviratidzo zvakafanana asi vane mazinga akaderera eFeNO. Kuwanda kweFeNO nguva dzose (semuenzaniso, >35-40 ppb muvanhu vakuru) mumurwere ane zviratidzo zvinoratidza (kukosora, kufema, kudzikamisa kufamba kwemhepo) ikozvino kunopa humbowo hwakanaka hwe endotype yeT2-high, kunyangwe kurapwa kusati kwaitwa.
Kutsigira Kuongororwa Kwezvirwere Muzviitiko Zvinonetsa: Kune varwere vane zviratidzo zvisingawanzoitiki kana apo mhedzisiro ye spirometry isinganyatsojeka kana kuti yakajairika panguva yekuongororwa, FeNO yakakwira inogona kuva humbowo hwakakosha hunoratidza kuzvimba kweT2. Inobatsira kufambisa kuongororwa kubva kune kwakavakirwa chete pazviratidzo zvinoshanduka kuenda kune kune kwaisanganisira siginecha yemuviri.
Kuzivisa Maitiro Ekurapa Kwekutanga: Nekuisa FeNO padanho rekuongorora, vanachiremba vanogona kupatsanura kurapwa zvine musoro kubva pakutanga. FeNO yakakwira haingotsigire kuongororwa kweasthma chete asiwo inofanotaura zvakasimba mhinduro yakanaka kune kurapa kwekutanga kweICS. Izvi zvinoita kuti nzira yekurapa ive yakasarudzika, "yekutanga chaiyo", zvichigona kuvandudza kudzora kwekutanga uye mhedzisiro.
Zvinokonzera Kliniki uye Kubatanidzwa
Gwaro re2025 rinokurudzira kubatanidza bvunzo dzeFeNO muongororo yekutanga yekuongorora kana paine fungidziro yeasthma uye mukana wekuwana bvunzo uripo. Dudziro yacho inotevera modhi yakakamurwa:
High FeNO (>50 ppb muvanhu vakuru): Inotsigira zvakanyanya kuongororwa kwechirwere cheasthma cheT2-high uye inofanotaura kuti ICS inogona kupindura sei.
FeNO yepakati (25-50 ppb muvanhu vakuru): Inofanira kutsanangurwa zvichienderana nekiriniki; inogona kureva kuzvimba kweT2 asi inogona kukanganiswa neatopy, kusangana neallergen munguva pfupi yapfuura, kana zvimwe zvinhu.
Low FeNO (<25 ppb muvanhu vakuru): Inoita kuti kuzvimba kweT2-high kuve kushoma, zvichiita kuti pave nekuongororwa kwakasiyana (semuenzaniso, kusashanda zvakanaka kwezwi, asthma phenotypes isiri yeT2, COPD) kana zvikonzero zvisingazvimbi zvezviratidzo.
Iyi update haiiti kuti FeNO ive bvunzo yekuongorora yega asi inoiisa seimwe yekuwedzera kwakasimba kune nhoroondo yekiriniki, maitiro ezviratidzo, uye bvunzo ye spirometry/reversibility. Inowedzera chikamu chekuona zvinhu nenzira isina kusarura chinovandudza chivimbo chekuongorora.
Mhedziso
GINA gwara ra2025 rinomiririra shanduko huru, richisimbisa mamiriro ekuongororwa kweFeNO kubva pakubatsira manejimendi kuenda kunotsigira kuongororwa kwechirwere cheType 2 asthma. Nekupa chiyero chakananga uye chakanangana chekuzvimba kweT2 kuri pasi, FeNO inopa simba vanachiremba kuti vaongorore zviratidzo zve phenotypic zvakananga pakutanga kusangana. Izvi zvinotungamira pakurapa kwekutanga kwakanangana uye kunoshanda, zvichienderana zvakakwana nechishuwo chemazuva ano chekurapa kwakarurama mukutarisira asthma. Sezvo mukana wekuwana tekinoroji yeFeNO uchikura, basa rayo mukuongorora nekutungamira kurapwa kwechirwere cheT2-high asthma rakagadzirirwa kuva chiyero chekutarisira, pakupedzisira chinangwa chemhedzisiro iri nani yemurwere kuburikidza nekupindira kwekutanga uye kwakarurama.
UBREATH Breath Gas Analysis System (BA200) chishandiso chekurapa chakagadzirwa uye chakagadzirwa ne e-LinkCare Meditech kuti chibatanidzwe neFeNO neFeCO bvunzo kuti zvipe chiyero nekukurumidza, chakarurama, uye chehuwandu kuitira kubatsira mukuongorora uye kurapwa kwekiriniki senge asthma nezvimwe zvirwere zvekufema zvisingaperi.
Nguva yekutumira: Ndira-23-2026