伴有和不伴有呼吸道阻塞的吸烟者中辣椒素咳嗽敏感性试验
2009/03/27
背景：咳嗽是吸烟者的常见症状，常在呼吸道阻塞前出现。我们检测长期吸烟是否与尚未出现咳嗽时辣椒素咳嗽反应增强有关。
方法：我们在肺功能正常的无症状吸烟者（n=68, FEV1为99.3%±2.1%预计值）和无咳嗽症状、已确诊COPD的患者（n=42，FEV1为57.0%±2.6%预计值）中检测这种相关性，以健康的不吸烟的志愿者作为对照（n=92，FEV1为100.6%±1.7%预计值）。应用增加辣椒素浓度咳嗽激发试验，我们记录能够引发2次（C2）和5次（C5）及5次以上咳嗽的辣椒素浓度。
结果：因为对照组中女性的C2和C5低于男性，我们在每组中按照性别分析数据。与不吸烟者（1.90±0.09 mmol/L）相比，无症状的吸烟者（1.56±0.11 mmol/L, p<0.05）和COPD患者（1.44±0.14 mmol/L, p<0.01）的Log C5均降低。组间比较Log C2无差异。与男性相比（分别为1.045±0.088 mmol/L 和1.923±0.087 mmol/L），女性的log C2和log C5（分别为0.772±0.071 mmol/L和1.481±0.094 mmol/L）降低（log C2，p<0.05；log C5，p<0.001）。
结论：长期吸烟会增强辣椒素咳嗽反射，且这种情况在COPD的进展中也会持续。
（张永明 审校）
Blanc FX, et al. Respir Med. 2009 Jan 9.
Blanc FX, et al. Respir Med. 2009 Jan 9. [Epub ahead of print]
Capsaicin cough sensitivity in smokers with and without airflow obstruction.
BACKGROUND: Cough is a frequent symptom of cigarette smokers that often precedes the development of airflow obstruction. We determined whether chronic cigarette smoking is associated with an increase in capsaicin cough response in the absence of cough.
METHODS: We examined this in asymptomatic smokers with normal lung function (n=68, FEV(1) 99.3+/-2.1% predicted) and in patients with established COPD without cough symptoms (n=42; FEV(1) 57.0+/-2.6% predicted), using healthy non-smoking volunteers as control (n=92; FEV(1) 100.6+/-1.7% predicted). Using an incremental capsaicin concentration challenge protocol, we recorded the concentrations that induced 2 (C2) and 5 or more coughs (C5).
RESULTS: Because females have a lower C2 and C5 than males in the control group, we analysed the data in each group according to gender. Log C5 was decreased both in asymptomatic smokers (1.56+/-0.11mumol/L, p<0.05) and in COPD patients (1.44+/-0.14mumol/L, p<0.01) when compared to non-smokers (1.90+/-0.09mumol/L). Log C2 did not differ between groups. Log C2 and log C5 were decreased in women (0.772+/-0.071mumol/L and 1.481+/-0.094mumol/L, respectively) when compared to men (1.045+/-0.088mumol/L and 1.923+/-0.087mumol/L, respectively) (p<0.05 for log C2; p<0.001 for log C5).
CONCLUSION: We conclude that chronic cigarette smoking increases capsaicin cough reflex and that this remains so with the development of COPD.
方法：我们在肺功能正常的无症状吸烟者（n=68, FEV1为99.3%±2.1%预计值）和无咳嗽症状、已确诊COPD的患者（n=42，FEV1为57.0%±2.6%预计值）中检测这种相关性，以健康的不吸烟的志愿者作为对照（n=92，FEV1为100.6%±1.7%预计值）。应用增加辣椒素浓度咳嗽激发试验，我们记录能够引发2次（C2）和5次（C5）及5次以上咳嗽的辣椒素浓度。
结果：因为对照组中女性的C2和C5低于男性，我们在每组中按照性别分析数据。与不吸烟者（1.90±0.09 mmol/L）相比，无症状的吸烟者（1.56±0.11 mmol/L, p<0.05）和COPD患者（1.44±0.14 mmol/L, p<0.01）的Log C5均降低。组间比较Log C2无差异。与男性相比（分别为1.045±0.088 mmol/L 和1.923±0.087 mmol/L），女性的log C2和log C5（分别为0.772±0.071 mmol/L和1.481±0.094 mmol/L）降低（log C2，p<0.05；log C5，p<0.001）。
结论：长期吸烟会增强辣椒素咳嗽反射，且这种情况在COPD的进展中也会持续。
（张永明 审校）
Blanc FX, et al. Respir Med. 2009 Jan 9.
Blanc FX, et al. Respir Med. 2009 Jan 9. [Epub ahead of print]
Capsaicin cough sensitivity in smokers with and without airflow obstruction.
BACKGROUND: Cough is a frequent symptom of cigarette smokers that often precedes the development of airflow obstruction. We determined whether chronic cigarette smoking is associated with an increase in capsaicin cough response in the absence of cough.
METHODS: We examined this in asymptomatic smokers with normal lung function (n=68, FEV(1) 99.3+/-2.1% predicted) and in patients with established COPD without cough symptoms (n=42; FEV(1) 57.0+/-2.6% predicted), using healthy non-smoking volunteers as control (n=92; FEV(1) 100.6+/-1.7% predicted). Using an incremental capsaicin concentration challenge protocol, we recorded the concentrations that induced 2 (C2) and 5 or more coughs (C5).
RESULTS: Because females have a lower C2 and C5 than males in the control group, we analysed the data in each group according to gender. Log C5 was decreased both in asymptomatic smokers (1.56+/-0.11mumol/L, p<0.05) and in COPD patients (1.44+/-0.14mumol/L, p<0.01) when compared to non-smokers (1.90+/-0.09mumol/L). Log C2 did not differ between groups. Log C2 and log C5 were decreased in women (0.772+/-0.071mumol/L and 1.481+/-0.094mumol/L, respectively) when compared to men (1.045+/-0.088mumol/L and 1.923+/-0.087mumol/L, respectively) (p<0.05 for log C2; p<0.001 for log C5).
CONCLUSION: We conclude that chronic cigarette smoking increases capsaicin cough reflex and that this remains so with the development of COPD.
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慢性持续咳嗽患者喉功能异常的特征
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慢性咳嗽中客观咳嗽频度的性别差异和预测因子
