Fração exalada de óxido nítrico no diagnóstico e controle da asma em adolescentes
Exhaled nitric oxide in the diagnosis and management of asthma in teenagers
Rosa M. de Carvalho; Beatriz J. V. Aarestrup; Fernanda R. R. da Silva; Nayara C. Goretti; Fernando M. Aarestrup
Resumo
Objetivo: Avaliar a presença de inflamação nas vias aéreas inferiores, assim como a relação desta com o padrão das respostas ao questionário ISAAC, com o nível de controle da asma e com a percepção de qualidade de vida (QV), em adolescentes com asma detectada pelo questionário ISAAC. Métodos: Estudo transversal, em que 27 adolescentes com asma detectada pelo questionário ISAAC realizaram espirometria, medidas de FeNO, avaliação do controle da asma através do Asthma Control Questionnaire (ACQ-7) e avaliação da QV pelo Paediatric Asthma Quality of Life Questionnaire (PAQLQ). Resultados: Treze meninas e 14 meninos com idade média de 14,6 anos apresentaram média de 50,6 partes por bilhão (ppb) de FeNO; e 1,29 de escore no ACQ-7. No PAQL, apresentaram 5,02 no escore total, com 4,87 no domínio “sintomas”; 4,30 no domínio “limitação física”; e 5,67 no domínio “emocional”. Os níveis de FeNO apresentaram associação com resposta afirmativa às questões 1 e 5 do ISAAC, além de correlação positiva com os escores do ACQ-7 (r = 0,417; p = 0,030) e correlação inversa com os escores de QV (r = -0,578; p = 0,002). Conclusão: O grau de inflamação das vias aéreas inferiores, avaliado através da FeNO, é elevado, confirmando o diagnóstico de asma e se relacionando inversamente com o controle da doença e a qualidade de vida.
Palavras-chave
Abstract
Objective: To assess the presence of inflammation in the lower airways, as well as the correlation between inflammation and pattern of ISAAC questionnaire responses, with level of asthma control and quality of life (QoL) perception, in adolescents with asthma detected by the ISAAC questionnaire. Methods: Cross-sectional study, with 27 adolescents with asthma detected by ISAAC questionnaire who underwent spirometry, FeNO measurements, assessment of asthma control using the Asthma Control Questionnaire (ACQ-7) and assessment of QoL by the Paediatric Asthma Quality of Life Questionnaire (PAQLQ). Results: Thirteen girls and 14 boys with mean age of 14.6 years had mean of 50.6 parts per billion (ppb) of FeNO; and score of 1.29 on ACQ-7. On PAQL, they presented 5.02 for total score and 4.87 for "symptoms"; 4.30 on "physical limitation"; and 5.67 for "emotional" domains. FeNO levels were associated with an affirmative answer to questions 1 and 5 of the ISAAC questionnaire. In addition, there was a positive correlation with the ACQ-7 scores (r = 0.417; p = 0.030) and an inverse correlation with QoL scores (r = -0.578, p = 0.002). Conclusion: The degree of inflammation of the lower airways as measured by FeNO is elevated, confirming the diagnosis of asthma and correlating inversely with disease control and quality of life.
Keywords
Referências
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Submetido em:
26/03/2014
Aceito em:
06/04/2015
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