％0期刊论文％A王，凯％A Verbakel，扬Y.％A奥凯，杰森％A弗莱明努里，亚历山大％A蒲鲁贤，乔什％A·罗伯茨，尼亚％A原田，德宏％A热田，良％A高桥，和久％A森，孝％A藤泽，智之％A白井，俊％A Kawayama，友隆％A井上，浩正％A拉扎勒斯，斯蒂芬％A Szefler，斯坦利％A Martinez的，费尔南多％A肖，多米尼克％APavord，伊恩D.％A托马斯，麦克％T使用分数呼出的一氧化氮以指导降压治疗决定在哮喘患者的系统综述和个体患者数据荟萃分析％d 2020％R 10.1183 / 13993003.02150-2019％Ĵ欧洲呼吸杂志％P 1902150％V 55％N 5％X背景高呼出的一氧化氮组分（FENO）水平与哮喘恶化的风险更大。但是，目前尚不清楚如何FENO可以用于指导吸入糖皮质激素减少安全（ICS）剂量的哮喘患者。This study assesses the ability of FENO to guide ICS reductions.Methods Systematic searching of electronic databases identified prospective observational studies and randomised controlled trials which recruited participants with mild-to-moderate asthma aged ≥12 years and measured FENO before reducing ICS. We performed multilevel mixed-effects logistic regression in relation to acute exacerbations and estimated each participant's exacerbation risk using our logistic regression model.Results We included data from seven out of eight eligible studies, representing 384 participants. ICS doses were halved in four studies and withdrawn in three studies. A baseline FENO measurement of ≥50 ppb was associated with increased risk of exacerbations (crude OR 3.14, 95% CI 1.41–7.00, p=0.005; adjusted OR 3.08, 95% CI 1.36–6.98, p=0.007) and corresponded to an estimated exacerbation risk cut-off of 15%. Reducing ICS when estimated exacerbation risk was <15% versus <10% would result in fewer patients remaining on the same ICS dose (40 (10.4%) out of 384 versus 141 (36.7%) out of 384), but similar proportions of patients avoiding exacerbations (222 (91.4%) out of 243, 95% CI 87.1–94.6% versus 311 (90.4%) out of 344, 95% CI 86.8–93.3%).Conclusion In patients with mild-to-moderate asthma, gradual ICS reduction when FENO is <50 ppb may help decrease ICS use without increasing exacerbations. Future research should aim to validate these findings in larger populations.In nonsmoking patients with mild-to-moderate well-controlled asthma, stepping down treatment when FENO is <50 ppb reduces prescribing of inhaled corticosteroids without increasing exacerbations http://bit.ly/2SKaxSt %U //www.qdcxjkg.com/content/erj/55/5/1902150.full.pdf