咳嗽敏感性和咳嗽变异性哮喘的比较研究

目的探讨咳嗽敏感性在咳嗽变异性哮喘（cough variant asthma,CVA）咳嗽发生中的作用差异及机制。方法 68例CVA按辣椒素咳嗽阈值C5分为增高组（21例）和正常组（47例）,另设正常对照组（26例）。比较三组间咳嗽症状积分、肺功能和诱导痰细胞学改变,并用酶联免疫法检测诱导痰上清液中白细胞介素-8（interleukin-8,IL-8）及中性粒细胞弹性蛋白酶（neutrophil elastase,NE）水平。结果咳嗽敏感性增高组CVA咳嗽程度重于正常组CVA（4.0±1.0 vs 3.1±0.9,P〈0.01）。CVA与健康志愿者间肺功能虽无差别,但诱导痰中细胞总数及中性白细胞比例增高,IL-8和NE也增高。其中咳嗽敏感性增高组CVA中性粒细胞比例高于正常组CVA（50.1±25.4）%vs（36.6±19.7）%,P〈0.05,伴有IL-8（360.4±181.2）pg/ml vs（228.0±107.9）pg/ml,P〈0.01和NE（94.1±16.9）ng/ml vs（67.6±12.9）ng/ml,P〈0.01,有关指标进一步升高。相关性分析示IL-8与中性粒细胞比例、NE均呈正相关（P〈0.01）,NE与Log C5呈负相关（P〈0.05）。结论 CVA可分为咳嗽敏感性增高和正常两种亚型。中性粒细胞在气道浸润和活化程度不同可能是造成CVA咳嗽敏感性差异的重要原因。

Comparative study of cough variant asthma and cough reflex sensitivity

Objectives To study the different effects of cough reflex sensitivity on the pathogenesis of cough in CVA and to explore its underlying mechanism.Methods Sixty-eight patients with CVA were divided into two subgroups according to the established normal value of cough sensitivity threshold C5: CVA with increased(21 cases) or normal(47 cases) cough reflex sensitivity.Twenty-six healthy volunteers were enrolled as control group.Changes in cough symptom score,lung function parameters,total cell number and differ...