Bronchial sensitivity and bronchial reactivity in children with cough variant asthma
Bronchial sensitivity and bronchial reactivity in children with cough variant asthma
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DOI：
10.1378/chest.128.4.2427
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发表时间：
2005-10-01
期刊：
影响因子：
9.6
通讯作者：
Morikawa, A
中科院分区：
文献类型：
--
作者：
Mochizuki, H;Arakawa, H;Morikawa, A
背景：咳嗽变异性哮喘 (CVA) 在一些患有慢性咳嗽但没有喘息的儿童中被诊断出来。然而，儿童CVA的确切机制尚不清楚。目的：评估经典哮喘和CVA儿童气道的生理差异，研究呼吸阻力（Rrs）的乙酰甲胆碱剂量反应曲线。患者和方法：31例慢性咳嗽儿童（年龄范围，5至14岁；男19例，女12例；平均年龄8.5岁）在吸入乙酰甲胆碱的基础上诊断为CVA。使用振荡方法进行挑战。为了进行比较，该研究包括 86 名年龄匹配的典型哮喘儿童（年龄范围，5 至 15 岁；42 名男孩和 44 名女孩；平均年龄，9.5 岁）、25 名年龄匹配的咳嗽儿童（年龄范围，5 至 15 岁；17 名男孩和 8 名女孩；平均年龄，8.8 岁）和 23 名年龄匹配的对照受试者（8 名男孩和 15 名女孩；平均年龄，9.2 岁）年）。乙酰甲胆碱的连续剂量加倍，直到 Rrs 较基线增加 200%。 Rrs拐点处的乙酰甲胆碱累积剂量被认为代表了支气管对吸入乙酰甲胆碱的敏感性（乙酰胆碱最小剂量[Dmin]）。乙酰甲胆碱剂量反应曲线 (SRrs) 的斜率被认为代表支气管反应性，通过 Rrs 曲线的增加来测量。 结果：典型哮喘患者和 CVA 患者的 Dmin 值显着低于咳嗽患者和对照受试者。典型哮喘患者和 CVA 患者之间的 Dmin 值没有显着差异。 CVA 患者的 SRrs 值显着低于典型哮喘患者、咳嗽患者和对照受试者（分别为 p < 0.05、p < 0.01 和 p < 0.01）。经典哮喘患者、咳嗽患者和对照受试者之间的SRrs值没有显着差异。结论：这些数据表明，CVA儿童的支气管反应性显着低于经典哮喘儿童，并且这种特异性对CVA儿童的长时间咳嗽无喘息有影响。
Background: Cough variant asthma (CVA) is diagnosed in some children with chronic cough who do not have wheezing. However, the precise mechanism of CVA in children is unclear.Objective: To evaluate the physiologic differences in the airways of children with classic asthma and CVA, the methacholine dose-response curves of respiratory resistance (Rrs) were studied.Patients and methods: CVA was diagnosed in 31 children with chronic cough (age range, 5 to 14 years; 19 boys and 12 girls; mean age, 8.5 years) on the basis of methacholine inhalation challenge using an oscillation method. For comparison, the study included 86 age-matched children with classic asthma (age range, 5 to 15 years; 42 boys and 44 girls; mean age,. 9.5 years), 25 age-matched children with cough (age range, 5 to 15 years; 17 boys and 8 girls; mean age, 8.8 years), and 23 age-matched control subjects (8 boys and 15 girls; mean age, 9.2 years). Consecutive doses of methacholine were doubled until a 200% increase in Rrs from baseline was reached. The cumulative dose of methacholine at the inflection point of Rrs was considered to represent the bronchial sensitivity to inhaled methacholine (minimum dose of methacholine [Dmin]). The slope of the methacholine dose-response curve (SRrs), which was considered to represent bronchial reactivity, was measured from the increasing Rrs curve.Results: The values of Dmin in classic asthma patients and in CVA patients were significantly lower than those for cough patients and control subjects. There was no significant difference in the values of Dmin between the classic asthma and CVA patients. The value of SRrs in CVA patients was significantly lower than that in classic asthma patients, cough patients, and control subjects (p < 0.05, p < 0.01, and p < 0.01, respectively). There was no significant difference in the value of SRrs between classic asthma patients, cough patients, and control subjects.Conclusions: These data show that bronchial reactivity in the children with CVA was significantly lower than that in the children with classic asthma, and this specificity has an effect on prolonged cough without wheezing in children with CVA.