慢性咳嗽影响重度哮喘控制水平和生活质量
2025/03/31
摘要
背景与目的：重度哮喘患者中慢性咳嗽的患病率和临床意义尚未明确。作者旨在通过纵向分析，探讨重度哮喘患者中慢性咳嗽与哮喘控制及生活质量（QoL）之间的关系。
方法：纳入韩国重度哮喘注册登记患者基线和 6个月随访数据进行分析。慢性咳嗽定义为基线和 6个月时咳嗽视觉模拟量表（VAS）评分均≥40 分。比较了重度哮喘合并或不合并慢性咳嗽的基线特征和临床结局。采用广义估计方程（GEE）分析来确定慢性咳嗽与重度哮喘的哮喘控制及生活质量评分之间的关联。
结果：共纳入 286 名重度哮喘患者，其中116 名（40.6%）合并有慢性咳嗽。与不合并慢性咳嗽相比，合并慢性咳嗽患者的基线咳嗽和喘息相关VAS评分均更高（均 P < 0.001），哮喘控制更差（P < 0.001），生活质量更差（严重哮喘问卷 [SAQ] 和欧洲五维健康量表 [EQ-5D] 指数，均 P < 0.001）。在随访期间，较不合并慢性咳嗽的重度哮喘，合并慢性咳嗽重度哮喘使用口服糖皮质激素的频率更高（58.6% vs 38.6%，P = 0.010），且哮喘急性发作频率也更高（48.3% vs 28.6%，P = 0.009）。调整了混杂因素后，发现慢性咳嗽是重度哮喘控制不佳、较低的SAQ评分以及较低的EQ-5D指数的独立影响因素。
结论：重度哮喘合并慢性咳嗽与疾病控制不佳以及生活质量差有关。因此，重度哮喘的慢性咳嗽需要进一步评估和管理。
关键词： 慢性咳嗽；哮喘；患者报告结局指标
文献来源：（Lee H Y, Lee Y, Lee S E, et al. Relationships between chronic cough and asthma control and quality of life in patients with severe asthma: a 6-month longitudinal analysis[J]. J Allergy Clin Immunol Pract , 2025: S2213219825000479. DOI: 10.1016/j.jaip.2025.01.006.）
背景与目的：重度哮喘患者中慢性咳嗽的患病率和临床意义尚未明确。作者旨在通过纵向分析，探讨重度哮喘患者中慢性咳嗽与哮喘控制及生活质量（QoL）之间的关系。
方法：纳入韩国重度哮喘注册登记患者基线和 6个月随访数据进行分析。慢性咳嗽定义为基线和 6个月时咳嗽视觉模拟量表（VAS）评分均≥40 分。比较了重度哮喘合并或不合并慢性咳嗽的基线特征和临床结局。采用广义估计方程（GEE）分析来确定慢性咳嗽与重度哮喘的哮喘控制及生活质量评分之间的关联。
结果：共纳入 286 名重度哮喘患者，其中116 名（40.6%）合并有慢性咳嗽。与不合并慢性咳嗽相比，合并慢性咳嗽患者的基线咳嗽和喘息相关VAS评分均更高（均 P < 0.001），哮喘控制更差（P < 0.001），生活质量更差（严重哮喘问卷 [SAQ] 和欧洲五维健康量表 [EQ-5D] 指数，均 P < 0.001）。在随访期间，较不合并慢性咳嗽的重度哮喘，合并慢性咳嗽重度哮喘使用口服糖皮质激素的频率更高（58.6% vs 38.6%，P = 0.010），且哮喘急性发作频率也更高（48.3% vs 28.6%，P = 0.009）。调整了混杂因素后，发现慢性咳嗽是重度哮喘控制不佳、较低的SAQ评分以及较低的EQ-5D指数的独立影响因素。
结论：重度哮喘合并慢性咳嗽与疾病控制不佳以及生活质量差有关。因此，重度哮喘的慢性咳嗽需要进一步评估和管理。
关键词： 慢性咳嗽；哮喘；患者报告结局指标
文献来源：（Lee H Y, Lee Y, Lee S E, et al. Relationships between chronic cough and asthma control and quality of life in patients with severe asthma: a 6-month longitudinal analysis[J]. J Allergy Clin Immunol Pract , 2025: S2213219825000479. DOI: 10.1016/j.jaip.2025.01.006.）
（南方医科大学南方医院 黄海伦 龚钊乾 赵文驱 赵海金）
Abstract
Background：The prevalence and clinical implications of chronic cough (CC) in patients with severe asthma receiving asthma treatment remain relatively unknown.
Objective：This study aimed to evaluate the relationships between CC and asthma control and quality of life (QoL) in patients with severe asthma through longitudinal analysis.
Methods：Baseline and 6-month follow-up data from the Korean Severe Asthma Registry were analyzed. CC was defined as a cough visual analog scale (VAS) score of ≥40 at both baseline and 6 months. Demographic parameters and clinical outcomes were compared between patients with severe asthma and CC and those without CC. Generalized estimating equation (GEE) analysis was performed to identify associations of CC with asthma control and QoL scores.
Results：Of the total 286 participants with severe asthma, 116 (40.6%) were defined as having CC. Patients with CC had higher baseline cough and wheeze severity VAS scores (all P < .001), poorer asthma control (P < .001), and worse QoL (Severe Asthma Questionnaire [SAQ] and Euro-QoL 5-Dimension [EQ-5D] index, all P < .001) than those without CC. During the follow-up, patients with CC were more frequently exposed to oral corticosteroids (58.6% vs 38.6%, P = .010) and experienced more frequent asthma exacerbations (48.3% vs 28.6%, P = .009) than those without CC. GEE analysis revealed that CC was independently associated with poor asthma control, lower SAQ scores, and a lower EQ-5D index after adjusting for confounders.
Conclusion：The presence of CC was associated with worse asthma control and QoL in patients with severe asthma. Further studies are warranted to better evaluate and manage CC in these patients.
Key words：Chronic cough; Asthma; Patient-reported outcome measuresObjective：This study aimed to evaluate the relationships between CC and asthma control and quality of life (QoL) in patients with severe asthma through longitudinal analysis.
Methods：Baseline and 6-month follow-up data from the Korean Severe Asthma Registry were analyzed. CC was defined as a cough visual analog scale (VAS) score of ≥40 at both baseline and 6 months. Demographic parameters and clinical outcomes were compared between patients with severe asthma and CC and those without CC. Generalized estimating equation (GEE) analysis was performed to identify associations of CC with asthma control and QoL scores.
Results：Of the total 286 participants with severe asthma, 116 (40.6%) were defined as having CC. Patients with CC had higher baseline cough and wheeze severity VAS scores (all P < .001), poorer asthma control (P < .001), and worse QoL (Severe Asthma Questionnaire [SAQ] and Euro-QoL 5-Dimension [EQ-5D] index, all P < .001) than those without CC. During the follow-up, patients with CC were more frequently exposed to oral corticosteroids (58.6% vs 38.6%, P = .010) and experienced more frequent asthma exacerbations (48.3% vs 28.6%, P = .009) than those without CC. GEE analysis revealed that CC was independently associated with poor asthma control, lower SAQ scores, and a lower EQ-5D index after adjusting for confounders.
Conclusion：The presence of CC was associated with worse asthma control and QoL in patients with severe asthma. Further studies are warranted to better evaluate and manage CC in these patients.
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增加每日步数或可减少成年人未来发生哮喘的风险
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成人轻度哮喘急性加重的风险因素评估
