Abstract
Zusammenfassung. Die Überprüfung des Raucherstatus mittels Biomarkern ist wichtig für Behandlungsentscheidungen von Patienten mit rauchbedingten Erkrankungen. Cotinin ist derzeit der beste Biomarker zur Dokumentation des Nikotinkonsums. Eine kostengünstige Alternative zur Bestimmung des Raucherstatus ist die Messung von Carboxyhämoglobin (CO-Hb) in der Ausatmungsluft. Der Hauptnachteil von CO-Hb ist die kurze Halbwertszeit. Der entsprechende Grenzwert für den aktiven Nikotinkonsum in der Schweiz liegt bei 50 ng/ml oder mehr Cotinin im Urin bzw. 10 ng/ml und 12 ng/ml im Serum und Speichel. CO-Hb-Werte von mehr als 2 % deuten mit hoher Wahrscheinlichkeit auf aktives Rauchen hin, Werte über 3 % mit sehr hoher Wahrscheinlichkeit.
Abstract. Verification of smoking status by means of biomarkers is important for treatment decisions of patients with smoking-related diseases. Cotinine is currently the best biomarker to document nicotine consumption. A low cost alternative method to determine smoking status is by measurement of carboxyhemoglobin (CO-Hb) in the exhaled breath. The main disadvantage of CO-Hb is the short half-life. The appropriate cut-off value for active nicotine consumption in Switzerland is 50 ng/ml or higher cotinine in the urine or 10 ng/ml and 12 ng/ml in serum and saliva, respectively. CO-Hb levels greater than 2 % indicate smoking with high probability, levels above 3 % with very high probability.
Résumé. Vérifier le statut fumeur au moyen de biomarqueurs est important pour prendre des décisions thérapeutiques en cas de maladies relatées à la fumée. La mesure de la cotinine est actuellement le meilleur marqueur pour documenter la consommation de nicotine. Une méthode alternative à faible coût est la mesure de la carboxyhémoglobine(CO-Hb) dans la l’air exhalé. Le désavantage principal de la CO-Hb est sa courte demi-vie. La valeur seuil appropriée pour une consommation active de nicotine est en Suisse de 50 ng/ml ou plus de cotinine dans les urines ou 10 ng/ml et 12 ng/ml dans respectivement le sérum et la salive. Des taux de CO-Hb supérieurs à 2% indiquent une probabilité élevée de consommation de nicotine, des niveaux supérieurs à 3% une très haute probabilité.
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