科研之友
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摘要
Background Respiratory failure is a life-threatening and unpredictable complication of systemic sclerosis (SSc). A study was undertaken to assess the value of alveolar nitric oxide (NO) in predicting the risk of lung function deterioration leading to respiratory failure or death in patients with SSc. %26lt;br%26gt;Methods 105 patients with SSc were enrolled in this prospective cohort and were followed longitudinally over a 3-year period during which the risk of occurrence of deleterious events was analysed according to alveolar concentration (CANO), conducting airway output (J%26apos;awNO) and fractional concentration (FENO0.05) of exhaled NO measured at inclusion. Comparison was made between each NO parameter to predict the occurrence of deleterious events, defined as a 10% decrease in total lung capacity or forced vital capacity from baseline, or death. %26lt;br%26gt;Results The area under the receiver operating characteristic curve of CANO to predict the occurrence of the combined events was 0.84 (95% CI 0.76 to 0.92; p%26lt;0.001), which was significantly higher than those of J%26apos;(awNO) and FENO0.05 (p%26lt;0.001). A cut-off of CANO of 5.3 ppb had a sensitivity of 88% and a specificity of 62% for the prediction of the occurrence of combined events during follow-up, and was validated in an independent cohort of patients with SSc. Combined events occurred more frequently in patients whose CANO was %26gt;5.3 ppb. The adjusted HR for patients with CANO %26gt;5.3 ppb was 6.06 (95% CI 2.36 to 15.53; p%26lt;0.001). CANO accurately predicted the occurrence of combined events irrespective of forced vital capacity values or the presence of interstitial lung disease at baseline. %26lt;br%26gt;Conclusions Increased CANO accurately identifies patients with SSc with a high risk of developing lung function deterioration and may help to initiate early appropriate treatment.
- 出版日期2012-2
