哮喘联盟

   摘要
   背景：针对胃食管反流(GERD)、上气道咳嗽综合征(UACS)和咳嗽变异性哮喘(CVA)的治疗使慢性咳嗽患者取得了不同的获益。特发性或不明原因的咳嗽一直是存在于初级保健和专科诊所的一个重要的临床症状。最近的证据指出了慢性咳嗽和未治疗的阻塞性睡眠窒息症(OSA)的联系。
   方法：本研究为一项前瞻性观察研究，旨在评价治疗OSA对慢性咳嗽患者的影响。入组患者需完成GERO、UACS和CVA评估问卷，以及OSA和日间嗜睡度筛查问卷。基线及连续随访期间使用Leicester咳嗽问卷（LCQ）评价其咳嗽程度，同时也作为CPAP治疗对慢性咳嗽影响的主要测定结果。
   结果：37例患者未完成此研究，仅28例患者具有有效的随访LCQ评分，因此被纳入分析。基于STOP-BANG筛查问卷评分和整夜血氧测定的异常结果，28例患者中22例疑似有OSA。28例患者中19例经整夜多导睡眠图确诊为OSA，因此，本研究慢性咳嗽人群中OSA患病率为68%。因OSA而进行治疗的慢性咳嗽患者往往年龄更大，且其BMI指数明显高于无OSA的慢性咳嗽患者。，采用CPAP治疗慢性咳嗽患者的OSA能显著改善其LCQ评分。
   结论：OSA在慢性咳嗽患者中非常普遍。伴有慢性咳嗽和OSA的人往往是肥胖的，并且年龄更大。治疗慢性咳嗽患者的OSA能显著改善其健康状况。
 

（林江涛 审校）
Cough. 2013 Jul 11;9(1):19. [Epub ahead of print]

 

A longitudinal study of CPAP therapy for patients with chronic cough and obstructive sleep apnoea.

Sundar KM, Daly SE, Willis AM.

Abstract
BACKGROUND:Chronic cough patients are rendered therapies for gastro-esophageal reflux (GERD), upper airway cough syndrome (UACS) and cough-variant asthma (CVA) with varying benefit. Idiopathic or unexplained cough has emerged as an important clinical entity in both primary care and subspecialty clinics. Recent evidence points to a link between chronic cough and untreated obstructive sleep apnea (OSA).
METHODS:A prospective observational study was done to evaluate the effect of OSA therapy in patients with chronic cough. Patients enrolled into the study underwent questionnaires to evaluate for GERD, UACS and CVA along with screening questionnaires for OSA and daytime sleepiness. The Leicester cough questionnaire (LCQ) was done at baseline and during serial visits to evaluate cough intensity and was used as the primary outcome measure of the effect of CPAP therapy on chronic cough.
RESULTS:Out of 37 patients enrolled into the study, only 28 patients had follow up LCQ scores available and therefore underwent analysis. 22/28 patients were suspected to have OSA based on abnormal STOP-BANG screening questionnaire scores and overnight oximetry abnormalities. Of these 19/28 patients had overnight attended polysomnography with definitive diagnosis of OSA yielding a 68% prevalence of OSA in our chronic cough population. Chronic cough patients treated for OSA tended to be older with a significantly higher BMI than chronic cough patients without OSA. Significant improvement of LCQ scores occurred with CPAP therapy for OSA in chronic cough patients.
CONCLUSION:OSA is significantly prevalent in chronic cough patients. Subjects with chronic cough and OSA tend to be older and obese. Treatment of OSA in chronic cough patients yields significant improvement in their health status.
 

Cough. 2013 Jul 11;9(1):19. [Epub ahead of print]