Sex differences and predictors of objective cough frequency in chronic cough
Sex differences and predictors of objective cough frequency in chronic cough
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DOI：
10.1136/thx.2008.106237
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发表时间：
2009-05-01
期刊：
影响因子：
10
通讯作者：
Smith, J. A.
中科院分区：
文献类型：
--
作者：
Kelsall, A.;Decalmer, S.;Smith, J. A.
背景：在专家咳嗽诊所中，女性一直占多数，并且已知其咳嗽反射比男性更敏感。女性性别和其他患者特征是否与较高的咳嗽率相关尚不清楚。进行了一项研究，以确定在三级转诊诊所就诊的慢性咳嗽患者的客观咳嗽频率的预测因素。100例受试者（65名女性）平均（SD）年龄55.8岁（11.0）年，中位咳嗽持续时间4年（IQR 2.0-10.0）不明原因慢性咳嗽患者完成流量-容量环（1秒用力呼气量平均值（SD）103（15.2）%预测值;用力呼气流量（FEF 50）68.8（24.1）%预测值）、乙酰甲胆碱激发（42%阳性）、柠檬酸咳嗽反射敏感性（C5; 0.12 M（IQR 0.06-0.50））和莱斯特咳嗽问卷。24小时动态咳嗽监测进行了86名subjects;手动计数咳嗽被量化为爆炸性咳嗽sounds.Results的数量：女性咳嗽显着多于男性（几何平均值16.6咳嗽/小时（95%CI 13.1至21.0）比9.4咳嗽/小时（95%CI 6.4至13.9），p=0.01）。女性的咳嗽反射也比男性更敏感（中位数logC 5 - 0.9 M vs 20.6 M，p=0.002），但女性和男性的咳嗽相关生活质量相似（分别为12.0（3.6）和12.2（3.2），p=0.76）。线性回归分析显示，38.6%的咳嗽率变化可通过性别（p=0.01）、logC 5（p < 0.001）和年龄（p=0.002）预测，但不能通过肺功能或支气管高反应性预测。结论：动态客观咳嗽监测为慢性咳嗽的调节因素提供了新的见解。这些发现表明，在咳嗽的研究和设计测试新型止咳药的临床试验时，必须考虑性别和年龄的影响。
Background: Women are consistently over-represented in specialist cough clinics and known to have a more sensitive cough reflex than men. Whether female sex and other patient characteristics are associated with higher cough rates is not known. A study was conducted to determine the predictors of objective cough frequency in patients presenting to a tertiary referral clinic with chronic cough.Methods: 100 subjects (65 women) of mean (SD) age 55.8 (11.0) years and median cough duration 4 years (IQR 2.0-10.0) with unexplained chronic cough completed flow-volume loops (mean (SD) forced expiratory volume in 1 s 103 (15.2)% predicted; forced expiratory flow (FEF50) 68.8 (24.1)% predicted), methacholine challenge (42% positive), citric acid cough reflex sensitivity (C5; 0.12 M (IQR 0.06-0.50)) and the Leicester Cough Questionnaire. 24-h ambulatory cough monitoring was performed in 86 subjects; manually counted coughs were quantified as the number of explosive cough sounds per hour.Results: Women coughed significantly more than men (geometric mean 16.6 coughs/h (95% CI 13.1 to 21.0) vs 9.4 coughs/h (95% CI 6.4 to 13.9), p=0.01)). The cough reflex was also more sensitive in women than in men (median logC5 -0.9 M vs 20.6 M, p=0.002), but cough-related quality of life was similar in women and men (12.0 (3.6) and 12.2 (3.2), respectively, p=0.76). Linear regression analysis showed that 38.6% of the variation in cough rate was predicted by sex (p=0.01), logC5 (p < 0.001) and age (p=0.002) but not lung function or bronchial hyper-reactivity.Conclusions: Ambulatory objective cough monitoring provides novel insights into factors modulating chronic cough. These findings suggest that effects of sex and age must be taken into account in the study of cough and when designing clinical trials testing novel antitussive agents.