COPD患者对吸入辣椒素诱导的咳嗽敏感性与急性加重频率增加相关
2009/11/17
背景与目的：目前对于COPD患者急性加重的原因了解较少。本试验在COPD稳定期患者中研究咳嗽反射与之后急性加重频率之间的关系。
方法：该研究中的试验组和对照组样本人群均来自于某医院门诊。采用辣椒素刺激发生5次或5次以上咳嗽时辣椒素的指数浓度（log C5）评价咳嗽反射敏感性。对患者随后12个月内的COPD恶化情况进行回顾性分析，通过基于症状的病情日志来判定COPD的急性加重情况。
结果：共纳入45例COPD患者和10例对照者。COPD患者的平均log C5低于对照组（分别为0.97 [95% CI: 0.76-1.18]和1.26[95% CI: 0.81-1.71], P = 0.095）。在COPD患者中，log C5与血清CRP水平呈负相关（r = -0.36, P = 0.02），且与急性加重频率显著相关（r = -0.38, P = 0.01）。分段多元回归分析显示，咳嗽反射敏感性与COPD急性加重频率显著相关（r2 = 0.15, P = 0.01）。
结论：对于稳定期COPD患者，吸入辣椒素所诱发的咳嗽反射过敏可反映患者存在气道炎症，这些患者的COPD病情容易反复急性加重。
（刘国梁 审校）
Respirology. 2009 Sep 16.
Cough-reflex sensitivity to inhaled capsaicin in COPD associated with increased exacerbation frequency.
Terada K, Muro S, Ohara T, Haruna A, Marumo S, Kudo M, Ogawa E, Hoshino Y, Hirai T, Niimi A, Mishima M.
ABSTRACT Background and objective: The causes of exacerbations in COPD patients are poorly understood. This study examined the association between cough-reflex sensitivity in patients with stable COPD and the frequency of subsequent exacerbations.
Methods: The sampling frame for cases and controls for this study was patients attending a hospital outpatient clinic. cough-reflex sensitivity was evaluated using the log concentration of capsaicin causing five or more coughs (log C(5)). Subsequent COPD exacerbations were identified prospectively via symptom-based diaries over a 12-month period.
Results: The study group comprised 45 COPD subjects and 10 controls. Mean log C(5) was lower in the COPD group than in the control group (0.97 (95% confidence interval (CI): 0.76-1.18) versus 1.26 (95% CI: 0.81-1.71), P = 0.095). In the COPD group, log C(5) was negatively correlated with serum CRP level (r = -0.36, P = 0.02) and significantly associated with the exacerbation frequency (r = -0.38, P = 0.01). Stepwise multiple regression analysis showed that cough-reflex sensitivity was significantly associated with exacerbation frequency (r(2) = 0.15, P = 0.01).
Conclusions: Hypersensitivity of the cough reflex to inhaled capsaicin might reflect airway inflammation in stable COPD patients, which predisposes to frequent exacerbations.
Terada K, et al. Respirology. 2009 Sep 16.
方法：该研究中的试验组和对照组样本人群均来自于某医院门诊。采用辣椒素刺激发生5次或5次以上咳嗽时辣椒素的指数浓度（log C5）评价咳嗽反射敏感性。对患者随后12个月内的COPD恶化情况进行回顾性分析，通过基于症状的病情日志来判定COPD的急性加重情况。
结果：共纳入45例COPD患者和10例对照者。COPD患者的平均log C5低于对照组（分别为0.97 [95% CI: 0.76-1.18]和1.26[95% CI: 0.81-1.71], P = 0.095）。在COPD患者中，log C5与血清CRP水平呈负相关（r = -0.36, P = 0.02），且与急性加重频率显著相关（r = -0.38, P = 0.01）。分段多元回归分析显示，咳嗽反射敏感性与COPD急性加重频率显著相关（r2 = 0.15, P = 0.01）。
结论：对于稳定期COPD患者，吸入辣椒素所诱发的咳嗽反射过敏可反映患者存在气道炎症，这些患者的COPD病情容易反复急性加重。
（刘国梁 审校）
Respirology. 2009 Sep 16.
Cough-reflex sensitivity to inhaled capsaicin in COPD associated with increased exacerbation frequency.
Terada K, Muro S, Ohara T, Haruna A, Marumo S, Kudo M, Ogawa E, Hoshino Y, Hirai T, Niimi A, Mishima M.
ABSTRACT Background and objective: The causes of exacerbations in COPD patients are poorly understood. This study examined the association between cough-reflex sensitivity in patients with stable COPD and the frequency of subsequent exacerbations.
Methods: The sampling frame for cases and controls for this study was patients attending a hospital outpatient clinic. cough-reflex sensitivity was evaluated using the log concentration of capsaicin causing five or more coughs (log C(5)). Subsequent COPD exacerbations were identified prospectively via symptom-based diaries over a 12-month period.
Results: The study group comprised 45 COPD subjects and 10 controls. Mean log C(5) was lower in the COPD group than in the control group (0.97 (95% confidence interval (CI): 0.76-1.18) versus 1.26 (95% CI: 0.81-1.71), P = 0.095). In the COPD group, log C(5) was negatively correlated with serum CRP level (r = -0.36, P = 0.02) and significantly associated with the exacerbation frequency (r = -0.38, P = 0.01). Stepwise multiple regression analysis showed that cough-reflex sensitivity was significantly associated with exacerbation frequency (r(2) = 0.15, P = 0.01).
Conclusions: Hypersensitivity of the cough reflex to inhaled capsaicin might reflect airway inflammation in stable COPD patients, which predisposes to frequent exacerbations.
Terada K, et al. Respirology. 2009 Sep 16.
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吸入甘露醇激发试验在咳嗽评价中的应用
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呼出气一氧化氮在评价年轻成人慢性咳嗽患者中的作用
