病毒性上呼吸道感染对咳嗽急迫感的影响
2011/03/24
摘要
背景：近期，很多的研究关注到咳嗽动作之前的刺激感受在咳嗽中的作用，这种感受又被称之为咳嗽急迫感（UTC）。虽然之前一项研究显示，发生急性上呼吸道感染（URI）时存在暂时性的咳嗽敏感性增加，但是有关URI对UTC的影响尚未有研究。
方法：采用标准咳嗽刺激方法，我们在24名健康非吸烟成人中，检测URI时及URI康复后（4～8周后）的咳嗽反射敏感性，后者采用C2和C5表示（C2为诱导2次或更多咳嗽时的辣椒素浓度；C5为诱导5次或更多咳嗽时的辣椒素浓度）。我们同时检测首次出现URC感觉、但未出现咳嗽动作时的辣椒素浓度，将其定为Cu。此外，检测首次出现咳嗽时的辣椒素浓度（C1），并计算C1与Cu之间的差值，将其定为CΔ。
结果：与URI恢复后相比，URI时，表示咳嗽反射敏感性的C1(p = 0.033)、C5(p = 0.001)和咳嗽急迫感阈值Cu (p = 0.046)显著增加。咳嗽反射敏感性变化程度（C5）显著高于咳嗽急迫感阈值Cu(p = 0.044)。
结论：结果显示，UTC感受在URI时暂时性增加。我们的结果同时证实了前期一项研究的结果，即咳嗽反射敏感性在URI时暂时性增加。UTC阈值可以作为未来评价止咳药物疗效的一个相关终点指标。
（林江涛 审校）
Respir Med. 2010 Dec 22. [Epub ahead of print]
Effect of viral upper respiratory tract infection on the urge-to-cough sensation.
Dicpinigaitis PV, Bhat R, Rhoton WA, Tibb AS, Negassa A.
Albert Einstein College of Medicine, Montefiore Medical Center, 1825 Eastchester Road, Bronx, NY, USA.
Abstract
BACKGROUND: Recently, interest has emerged in the sensation of irritation that precedes the motor act of coughing; this phenomenon has been termed the urge-to-cough (UTC). Although one previous study has demonstrated a transient enhancement of cough reflex sensitivity during acute upper respiratory tract infection (URI), the effect of URI on UTC has not previously been investigated.
METHODS: Employing standard cough challenge methodology, we measured cough reflex sensitivity in 24 otherwise healthy adult nonsmokers during URI and again after recovery (4-8 weeks later) by determining C(2) and C(5), the concentrations of capsaicin inducing 2 or more and 5 or more coughs, respectively. In addition, we determined the capsaicin concentration at which the UTC sensation first occurred, without an associated motor cough, and termed it C(u). Furthermore, we determined the difference between concentrations of capsaicin inducing the first motor event of cough (C(1)) and C(u), and have termed it C(Δ).
RESULTS: During URI, cough reflex sensitivity as measured by C(1) (p = 0.033) and C(5) (p = 0.001), as well as the urge-to-cough threshold, C(u) (p = 0.046), were significantly enhanced compared to the post-recovery state. The degree of change in cough reflex sensitivity (C(5)) was significantly greater than that of the urge-to-cough threshold, C(u) (p = 0.044).
CONCLUSION: Our results demonstrate that the UTC sensation is transiently enhanced during URI. We also confirm the results of the lone previous study that demonstrated transient enhancement of cough reflex sensitivity during URI. The UTC threshold may represent an additional relevant end point to measure in future studies evaluating potential antitussive agents.
Respir Med. 2010 Dec 22. [Epub ahead of print]
背景：近期，很多的研究关注到咳嗽动作之前的刺激感受在咳嗽中的作用，这种感受又被称之为咳嗽急迫感（UTC）。虽然之前一项研究显示，发生急性上呼吸道感染（URI）时存在暂时性的咳嗽敏感性增加，但是有关URI对UTC的影响尚未有研究。
方法：采用标准咳嗽刺激方法，我们在24名健康非吸烟成人中，检测URI时及URI康复后（4～8周后）的咳嗽反射敏感性，后者采用C2和C5表示（C2为诱导2次或更多咳嗽时的辣椒素浓度；C5为诱导5次或更多咳嗽时的辣椒素浓度）。我们同时检测首次出现URC感觉、但未出现咳嗽动作时的辣椒素浓度，将其定为Cu。此外，检测首次出现咳嗽时的辣椒素浓度（C1），并计算C1与Cu之间的差值，将其定为CΔ。
结果：与URI恢复后相比，URI时，表示咳嗽反射敏感性的C1(p = 0.033)、C5(p = 0.001)和咳嗽急迫感阈值Cu (p = 0.046)显著增加。咳嗽反射敏感性变化程度（C5）显著高于咳嗽急迫感阈值Cu(p = 0.044)。
结论：结果显示，UTC感受在URI时暂时性增加。我们的结果同时证实了前期一项研究的结果，即咳嗽反射敏感性在URI时暂时性增加。UTC阈值可以作为未来评价止咳药物疗效的一个相关终点指标。
（林江涛 审校）
Respir Med. 2010 Dec 22. [Epub ahead of print]
Effect of viral upper respiratory tract infection on the urge-to-cough sensation.
Dicpinigaitis PV, Bhat R, Rhoton WA, Tibb AS, Negassa A.
Albert Einstein College of Medicine, Montefiore Medical Center, 1825 Eastchester Road, Bronx, NY, USA.
Abstract
BACKGROUND: Recently, interest has emerged in the sensation of irritation that precedes the motor act of coughing; this phenomenon has been termed the urge-to-cough (UTC). Although one previous study has demonstrated a transient enhancement of cough reflex sensitivity during acute upper respiratory tract infection (URI), the effect of URI on UTC has not previously been investigated.
METHODS: Employing standard cough challenge methodology, we measured cough reflex sensitivity in 24 otherwise healthy adult nonsmokers during URI and again after recovery (4-8 weeks later) by determining C(2) and C(5), the concentrations of capsaicin inducing 2 or more and 5 or more coughs, respectively. In addition, we determined the capsaicin concentration at which the UTC sensation first occurred, without an associated motor cough, and termed it C(u). Furthermore, we determined the difference between concentrations of capsaicin inducing the first motor event of cough (C(1)) and C(u), and have termed it C(Δ).
RESULTS: During URI, cough reflex sensitivity as measured by C(1) (p = 0.033) and C(5) (p = 0.001), as well as the urge-to-cough threshold, C(u) (p = 0.046), were significantly enhanced compared to the post-recovery state. The degree of change in cough reflex sensitivity (C(5)) was significantly greater than that of the urge-to-cough threshold, C(u) (p = 0.044).
CONCLUSION: Our results demonstrate that the UTC sensation is transiently enhanced during URI. We also confirm the results of the lone previous study that demonstrated transient enhancement of cough reflex sensitivity during URI. The UTC threshold may represent an additional relevant end point to measure in future studies evaluating potential antitussive agents.
Respir Med. 2010 Dec 22. [Epub ahead of print]
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慢性咳嗽评价和治疗的争论
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