低于冰点空气及多种触发因素与慢性咳嗽中哮喘发作密切相关
2019/06/13
摘要
背景：慢性咳嗽的管理依赖于对咳嗽疾病背景的认识。目前尚不清楚某些咳嗽触发因素是否与特定的疾病背景相关。
方法：此研究以电子邮件的形式面向芬兰两个城镇的公共服务人员。问卷包括12种触发因素。哮喘以医生对哮喘和喘息的诊断为标准。慢性鼻炎-鼻窦炎定义为鼻塞或鼻涕伴面部疼痛/压痛或嗅觉减退/丧失超过三个月。反流性食管炎定义为在最后三个月每周至少一天存在烧心和/或反流。特发性咳嗽定义为不符合其中任何一种诊断。
结果：有421名受试者咳嗽至少持续8周。低于冰点的空气作为咳嗽触发因素与哮喘的发生具有相关性，调整后的比值比（aOR）为7.27（4.09-12.9）（p <0.001）。咳嗽触发因素的数量在哮喘中比值最大，其次为慢性鼻窦炎、反流性食管炎和特发性咳嗽，其分别为（7.05（6.14-7.96）、4.94（4.35-5.54）、4.60（3.77-5.43）及3.44（3.02-3.86），p <0.001）。五个及以上触发因素的存在与哮喘的发生具有相关性，aOR为7.49（3.96-14.2）（p < 0.001）。无触发因素存在增加了特发性咳嗽的可能性（aOR 2.71（1.54-4.77），p=0.001）。
结论：低于冰点空气及多种触发因素与慢性咳嗽中哮喘发作密切相关。无触发因素存在增加了特发性咳嗽的可能性。
Subfreezing air as a cough trigger and multiple triggers are strongly associated with the presence of asthma in chronic cough.
Koskela HO, Lätti AM, Pekkanen J.
Abstract
BACKGROUND: Management of chronic cough relies on the recognition of cough background disorders. It is not known whether certain cough triggers are associated with specific background disorders.
METHODS: This was an e-mail study to public service employees of two towns in Finland. The questionnaire included twelve triggers. Current asthma was defined as doctor's diagnosis of asthma and current wheezing. Chronic rhinosinusitis was defined as either nasal blockage or nasal discharge and either facial pain/pressure or reduction/loss of smell for more than three months.Gastroesophageal reflux disease was defined as heartburn and/or regurgitation on at least one day a week during the last three months. Idiopathic cough was defined as absence of any of them.
RESULTS: There were 421 subjects with current cough that had lasted at least eight weeks. Subfreezing air as a cough trigger was associated with an adjusted odds ratio (aOR) of 7.27 (4.09-12.9), (p < 0.001), for current asthma. The number of cough triggers was largest in asthma, followed by chronic rhinosinusitis,gastroesophageal reflux, and idiopathic cough (7.05 (6.14-7.96), 4.94 (4.35-5.54), 4.60 (3.77-5.43), and 3.44 (3.02-3.86), respectively, p < 0.001).Presence of five or more triggers was associated with an aOR of 7.49 (3.96-14.2),(p < 0.001) for current asthma. Absence of any cough triggers increased the probability of idiopathic cough (aOR 2.71 (1.54-4.77), p = 0.001).
CONCLUSIONS: Subfreezing air as a cough trigger and multiple triggers are strongly associated with the presence of current asthma in chronic cough. Absence of any cough triggers increases the probability of idiopathic cough.
背景：慢性咳嗽的管理依赖于对咳嗽疾病背景的认识。目前尚不清楚某些咳嗽触发因素是否与特定的疾病背景相关。
方法：此研究以电子邮件的形式面向芬兰两个城镇的公共服务人员。问卷包括12种触发因素。哮喘以医生对哮喘和喘息的诊断为标准。慢性鼻炎-鼻窦炎定义为鼻塞或鼻涕伴面部疼痛/压痛或嗅觉减退/丧失超过三个月。反流性食管炎定义为在最后三个月每周至少一天存在烧心和/或反流。特发性咳嗽定义为不符合其中任何一种诊断。
结果：有421名受试者咳嗽至少持续8周。低于冰点的空气作为咳嗽触发因素与哮喘的发生具有相关性，调整后的比值比（aOR）为7.27（4.09-12.9）（p <0.001）。咳嗽触发因素的数量在哮喘中比值最大，其次为慢性鼻窦炎、反流性食管炎和特发性咳嗽，其分别为（7.05（6.14-7.96）、4.94（4.35-5.54）、4.60（3.77-5.43）及3.44（3.02-3.86），p <0.001）。五个及以上触发因素的存在与哮喘的发生具有相关性，aOR为7.49（3.96-14.2）（p < 0.001）。无触发因素存在增加了特发性咳嗽的可能性（aOR 2.71（1.54-4.77），p=0.001）。
结论：低于冰点空气及多种触发因素与慢性咳嗽中哮喘发作密切相关。无触发因素存在增加了特发性咳嗽的可能性。
（中日友好医院呼吸与危重症医学科 张 鑫 翻译 林江涛 审校）
（Respir Med. 2019 May 11;153:26-30. doi: 10.1016/j.rmed.2019.05.004.）
（Respir Med. 2019 May 11;153:26-30. doi: 10.1016/j.rmed.2019.05.004.）
Subfreezing air as a cough trigger and multiple triggers are strongly associated with the presence of asthma in chronic cough.
Koskela HO, Lätti AM, Pekkanen J.
Abstract
BACKGROUND: Management of chronic cough relies on the recognition of cough background disorders. It is not known whether certain cough triggers are associated with specific background disorders.
METHODS: This was an e-mail study to public service employees of two towns in Finland. The questionnaire included twelve triggers. Current asthma was defined as doctor's diagnosis of asthma and current wheezing. Chronic rhinosinusitis was defined as either nasal blockage or nasal discharge and either facial pain/pressure or reduction/loss of smell for more than three months.Gastroesophageal reflux disease was defined as heartburn and/or regurgitation on at least one day a week during the last three months. Idiopathic cough was defined as absence of any of them.
RESULTS: There were 421 subjects with current cough that had lasted at least eight weeks. Subfreezing air as a cough trigger was associated with an adjusted odds ratio (aOR) of 7.27 (4.09-12.9), (p < 0.001), for current asthma. The number of cough triggers was largest in asthma, followed by chronic rhinosinusitis,gastroesophageal reflux, and idiopathic cough (7.05 (6.14-7.96), 4.94 (4.35-5.54), 4.60 (3.77-5.43), and 3.44 (3.02-3.86), respectively, p < 0.001).Presence of five or more triggers was associated with an aOR of 7.49 (3.96-14.2),(p < 0.001) for current asthma. Absence of any cough triggers increased the probability of idiopathic cough (aOR 2.71 (1.54-4.77), p = 0.001).
CONCLUSIONS: Subfreezing air as a cough trigger and multiple triggers are strongly associated with the presence of current asthma in chronic cough. Absence of any cough triggers increases the probability of idiopathic cough.
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哮喘缓解的病理生理学研究进展
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肺计算模型和小气道在哮喘中的作用
