哮喘与非哮喘患者咳嗽频率模式的临床特点
2019/10/17
摘要
背景：咳嗽是哮喘的常见症状。目前咳嗽频率（CoFr）监测设备可客观测量咳嗽计数，并为评估哮喘提供一个新的终点。然而，对于CoFr在哮喘中的作用却知之甚少。
目的：研究哮喘患者和非哮喘患者CoFr的特点，探讨CoFr与哮喘病理生理指标的关系。
方法：对73例哮喘患者和63例非哮喘持续性咳嗽患者进行研究。在研究开始时，进行了莱斯特咳嗽问卷（LCQ健康状况）、咳嗽视觉模拟评分（VAS）、莱斯特咳嗽监护仪（LCM）、呼出气一氧化氮（FeNO）和肺功能测定。在哮喘患者中，若条件允许则进行气道高反应性（BHR）试验。对28例哮喘患者和17例非哮喘患者治疗前后进行LCQ、VAS和LCM检查。
结果：哮喘患者夜间睡眠时CoFr明显高于非哮喘患者。适当治疗后24小时CoFr显著降低，且与VAS和LCQ的变化相关。哮喘患者夜间咳嗽的改善程度大于白天（清醒）。哮喘患者CoFr与BHR显著相关，而与FeNO无关。
结论：哮喘患者夜间CoFr与BHR相关，治疗前明显高于非哮喘患者，且治疗后改善更多。监测夜间CoFr可为早期预测哮喘疗效提供独特而有价值的信息。
Clinical characteristics of cough frequency patterns in patients with and without asthma.
Fukuhara A, Saito J, Birring SS, Sato S, Uematsu M, Suzuki Y, Rikimaru M, Watanabe N, Saito M, Kawamata T, Umeda T, Togawa R, Sato Y, Koizumi T, Hirai K, Minemura H, Nikaido T, Kanazawa K, Tanino Y, Munakata M, Shibata Y.
Abstract
BACKGROUND: Cough is a frequent symptom of asthma. Cough frequency (CoFr) monitoring devices are now available to objectively measure cough counts and offer a novel endpoint to assess asthma. However, little is known about CoFr in asthma.
OBJECTIVE: The aims were firstly, to determine whether unique features of CoFr exist in asthmatic and non-asthmatic patients, and secondly, to evaluate relationships between CoFr and pathophysiological parameters of asthma.
METHODS: In the current study, 73 asthmatic and 63 non-asthmatic patients suffering from persistent cough were enrolled. At study entry, the Leicester Cough Questionnaire (LCQ health status), cough visual analogue scale (VAS), Leicester Cough Monitor (LCM), fractional exhaled nitric oxide (FeNO) measurements, and spirometry were performed. In asthmatic patients, bronchial hyperresponsiveness (BHR) test was conducted if applicable. In 28 asthmatic and 17 non-asthmatic patients, LCQ, VAS and LCM were examined before and after treatment.
RESULTS: CoFr during night-time (asleep) was significantly higher in asthmatic patients than in non-asthmatic patients. 24-hour CoFr significantly decreased after appropriate treatment and was correlated with changes in VAS and LCQ in all patients. The improvement in cough in asthmatic patients was greater during night-time than during daytime (awake). CoFr in asthmatic patients was significantly correlated with BHR, but not with FeNO.
CONCLUSIONS: In asthmatic patients, nocturnal CoFr can be associated with BHR, was significantly higher before treatment, but improved more after treatment compared to non-asthmatic patients. Monitoring nocturnal CoFr may provide unique and valuable information on making an early prediction of therapeutic effects in asthma.
背景：咳嗽是哮喘的常见症状。目前咳嗽频率（CoFr）监测设备可客观测量咳嗽计数，并为评估哮喘提供一个新的终点。然而，对于CoFr在哮喘中的作用却知之甚少。
目的：研究哮喘患者和非哮喘患者CoFr的特点，探讨CoFr与哮喘病理生理指标的关系。
方法：对73例哮喘患者和63例非哮喘持续性咳嗽患者进行研究。在研究开始时，进行了莱斯特咳嗽问卷（LCQ健康状况）、咳嗽视觉模拟评分（VAS）、莱斯特咳嗽监护仪（LCM）、呼出气一氧化氮（FeNO）和肺功能测定。在哮喘患者中，若条件允许则进行气道高反应性（BHR）试验。对28例哮喘患者和17例非哮喘患者治疗前后进行LCQ、VAS和LCM检查。
结果：哮喘患者夜间睡眠时CoFr明显高于非哮喘患者。适当治疗后24小时CoFr显著降低，且与VAS和LCQ的变化相关。哮喘患者夜间咳嗽的改善程度大于白天（清醒）。哮喘患者CoFr与BHR显著相关，而与FeNO无关。
结论：哮喘患者夜间CoFr与BHR相关，治疗前明显高于非哮喘患者，且治疗后改善更多。监测夜间CoFr可为早期预测哮喘疗效提供独特而有价值的信息。
(中日友好医院呼吸与危重症医学科 李红雯 摘译 林江涛 审校)
(J Allergy Clin Immunol Pract. 2019 Sep 18. pii: S2213-2198(19)30784-6. doi: 10.1016/j.jaip.2019.08.053.)
(J Allergy Clin Immunol Pract. 2019 Sep 18. pii: S2213-2198(19)30784-6. doi: 10.1016/j.jaip.2019.08.053.)
Clinical characteristics of cough frequency patterns in patients with and without asthma.
Fukuhara A, Saito J, Birring SS, Sato S, Uematsu M, Suzuki Y, Rikimaru M, Watanabe N, Saito M, Kawamata T, Umeda T, Togawa R, Sato Y, Koizumi T, Hirai K, Minemura H, Nikaido T, Kanazawa K, Tanino Y, Munakata M, Shibata Y.
Abstract
BACKGROUND: Cough is a frequent symptom of asthma. Cough frequency (CoFr) monitoring devices are now available to objectively measure cough counts and offer a novel endpoint to assess asthma. However, little is known about CoFr in asthma.
OBJECTIVE: The aims were firstly, to determine whether unique features of CoFr exist in asthmatic and non-asthmatic patients, and secondly, to evaluate relationships between CoFr and pathophysiological parameters of asthma.
METHODS: In the current study, 73 asthmatic and 63 non-asthmatic patients suffering from persistent cough were enrolled. At study entry, the Leicester Cough Questionnaire (LCQ health status), cough visual analogue scale (VAS), Leicester Cough Monitor (LCM), fractional exhaled nitric oxide (FeNO) measurements, and spirometry were performed. In asthmatic patients, bronchial hyperresponsiveness (BHR) test was conducted if applicable. In 28 asthmatic and 17 non-asthmatic patients, LCQ, VAS and LCM were examined before and after treatment.
RESULTS: CoFr during night-time (asleep) was significantly higher in asthmatic patients than in non-asthmatic patients. 24-hour CoFr significantly decreased after appropriate treatment and was correlated with changes in VAS and LCQ in all patients. The improvement in cough in asthmatic patients was greater during night-time than during daytime (awake). CoFr in asthmatic patients was significantly correlated with BHR, but not with FeNO.
CONCLUSIONS: In asthmatic patients, nocturnal CoFr can be associated with BHR, was significantly higher before treatment, but improved more after treatment compared to non-asthmatic patients. Monitoring nocturnal CoFr may provide unique and valuable information on making an early prediction of therapeutic effects in asthma.
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轻度哮喘患者短期内每日1次糠酸氟替卡松对乙酰甲胆碱诱导的支气管收缩的影响
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连续测定工作及休息期间呼出气一氧化氮在职业性哮喘方面的诊断
