비용을 동반한 만성 비부비동염에서 비강 및 호기 산화질소

Abstract

Background and Objectives : Nitric oxide(NO) is known to be an important mediator and inflammatory marker of human airway. The purpose of this study was to assess whether we can use the levels of nasal NO(nNO) and exhaled NO(eNO) as a tool of evaluation in chronic rhinosinusitis(CRS) with nasal polyp patients.

Subjects and Method : We used chemiluminescent analyser to measure nNO and eNO among normal controls(32) and CRS with polyp patients(30) and CRS with polyp & allergic rhinitis(AR) patients(27), and compared it with various clinical symptom parameters, laboratory datas and CT scores.

Results : Levels of nNO were significantly lower in patients of CRS with polyp(88.5±54.7 ppb) compared to controls(241.0±89.5 ppb). Levels of nNO in patients of CRS with polyp & AR(167.0±47.6 ppb) were significantly higher than CRS with polyp patients and lower than controls. A significant inverse relationship was observed between nNO and Sinus CT scores, severity of nasal obstruction and purulent rhinorrhea in CRS with polyp patients. Low values of nNO separated very well patients with CRS with polyp, and the cutoff value of less than 163 ppb was associated with the best combination of specificity (93%) and sensitivity (81%). Levels of eNO were significantly higher in patients of CRS with polyp(29.8±12.8 ppb) compared to controls(20.5±6.4 ppb) and a significant positive relationship was observed between eNO and CT scores.

Conclusion : The nasal NO would allow for better screening of CRS with polyp which eventually has to be treated with surgery. The upper airway disease could affect the lower airway inflammation and it reflects that “One airway, One disease”.