哮喘联盟

    摘要：对于慢性咳嗽，目前需要更为客观的检查方法。我们对在非哮喘性慢性咳嗽患者中应用甘露醇咳嗽激发试验进行了初步研究。我们对16名健康对照者和13名慢性咳嗽患者进行了试验。我们采用视觉模拟评分、辣椒素咳嗽敏感性试验评价咳嗽的严重程度，采用莱斯特咳嗽问卷和甘露醇激发咳嗽2次(C2)或5次(C5)来评价健康状况。在所有慢性咳嗽患者和6名健康对照者中，我们对1周内甘露醇激发咳嗽的重复性进行了评价。我们发现与对照组相比，慢性咳嗽患者C2和C5的几何平均值(logSEM)增加(C2: 4 (0.2)和16 (0.1); p = 0.04；C5: 63 (0.1)和251 (0.1); p=0.04）。与健康对照者相比，慢性患者的咳嗽视觉模拟评分、辣椒素诱导的咳嗽敏感性以及健康状况也有所改变，但这些慢性咳嗽患者的上述结果与C2和C5不具有相关性。组内相关分析评价甘露醇激发咳嗽重复性结果显示，C2＝0.53，C5＝0.59。C2和C5激发咳嗽的甘露醇截止剂量分别为62 mg/ml和550 mg/ml，他们区分咳嗽患者和健康对照者的敏感性分别为69％和62％，特异性分别为69％和81％。
    结果显示，甘露醇激发试验是一种新型咳嗽激发试验，但还需进一步的研究来证实我们的结果，评价其在鉴别引起慢性咳嗽的不同原因中的作用。

（刘国梁 审校）
Singapuri A, McKenna S, Brightling CE. Cough. 2008 Nov 18;4:10. [Epub ahead of print]

Singapuri A, McKenna S, Brightling CE. Cough. 2008 Nov 18;4:10.

ABSTRACT: There is a need for more objective outcome measures for chronic cough. In this pilot study we sought to investigate the utility of the mannitol challenge as a cough-provocation test in non-asthmatic chronic cough. We studied 16 healthy controls and 13 subjects with chronic cough. We assessed cough severity using a visual analogue score, capsaicin cough sensitivity, health status using the Leicester Cough Questionnaire and the dose of mannitol to cause 2 (C2) or 5 (C5) coughs. In all of the subjects with chronic cough and 6 of the controls we assessed the 1-week repeatability of the mannitol challenge. We found that in those subjects with chronic cough the geometric mean (logSEM) mannitol C2 and C5 was heightened compared to controls (C2: 4 (0.2) versus 16 (0.1); p = 0.04 and C5: 63 (0.1) versus 251 (0.1); p = 0.04). Cough visual analogue score, capsacin-induced cough sensitivity and health status were also altered in chronic cough compared to healthy controls, but in those subjects with chronic cough none of these outcomes was correlated with the mannitol C2 or C5. The repeatability of the mannitol challenge assessed by intraclass correlation was C2 = 0.53 and C5 = 0.59. A cut-off in the dose of mannitol of 62 mg/ml for C2 and 550 mg/ml for C5 had a sensitivity of 69 and 62% and specificity of 69 and 81% respectively to distinguish chronic coughers from healthy controls. In conclusion, the mannitol challenge my have potential as a novel cough challenge test and further work is required to extend our findings and to assess whether it has utility in different causes of chronic cough.