慢性咳嗽患者咳嗽敏感性的影响因素

目的探讨慢性咳嗽患者咳嗽敏感性的影响因素.方法按照慢性咳嗽病因诊断程序,人选并诊断慢性咳嗽患者.通过辣椒素咳嗽激发试验测定慢性咳嗽患者(治疗前)的气道咳嗽敏感性,以最先诱发5次或以上咳嗽的辣椒素溶液浓度(C5)的对数作为咳嗽阈值.分析咳嗽阈值与咳嗽积分、年龄、性别、病程、肺通气功能与诱导痰炎性细胞分类间的相关性.结果入选并获得明确诊断的不同病因慢性咳嗽患者共计150例.单因素相关分析显示,慢性咳嗽患者的咳嗽阈值与日间咳嗽积分、性别、年龄、咳嗽病程及诱导痰嗜酸细胞百分比有相关,r分别为-0.175、-0.305、-0.297、-0.238及0.173,P均<0.05;咳嗽阈值与夜间咳嗽积分、痰中性粒细胞百分比、痰巨噬细胞百分比、痰淋巴细胞百分比及肺通气功能第1秒用力呼气容积占预计值的百分比(FEV1/pred%)、用力呼气中段流速占预计值的百分比(MMEF/pred%)]均不相关,P均>0.05.多元线性回归分析显示,咳嗽阈值仅与性别、咳嗽病程有关(P均<0.01).结论咳嗽敏感性与咳嗽症状积分反映咳嗽程度的不同特征,性别与咳嗽病程可能影响慢性咳嗽患者的咳嗽敏感性.

Influence factors of cough reflex sensitivity in patients with chronic cough

Objective To investigate the influence factors of cough reflex sensitivity in patients with chronic cough. Methods Patients with chronic cough were recruited by using a diagnostic program. Cough reflex sensitivity was examined through eapsaicin cough challenge and the LgC5 (C5, the concentration of capsaicin causing five or more coughs ) was used as the index of cough threshold. Score of the severity of cough, age,gender, course of disease, pulmonary ventilation function (FEV1/pred%, MMEF/pred% )and cell differential of induced sputum (the percent of neutrophils, macrophages, lymphocytes, eosinophils)were also recorded for analysis. Results One hundred and fifty patients with different etiology of chronic cough involved in the study. Cough threshold of the patients was correlated with cough score at daytime (r=0.175, P<0.05 ), gender( r= -0.305, P<0.05), age (r=-0.297, P<0.05), course of disease (r=-0.238, P<0.05 )and the percent of eosinophils of induced sputum( r=0.173, P<0.05 ). Cough threshold was not significantly correlated with cough score at nighttime, the percent of neutrophils, macrophages, lymphocytes in induced sputum and FEV1/pred%, MMEF/pred% ( all P>0.05 ). Regression analysis showed that only gender and disease course were significantly corrclated with LgC5 ( all P<0.01 ). Conclusions Cough reflex sensitivity and cough score reflex the different aspect of the cough severity. The cough reflex sensitivity in patients with chronic cough may be affected by gender and course.