Coughing induced by airway irritation modulates the sensation of air hunger
Coughing induced by airway irritation modulates the sensation of air hunger
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DOI：
10.1113/jphysiol.2007.145276
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发表时间：
2008-01-15
影响因子：
5.5
通讯作者：
Ishikawa, Teruhiko
中科院分区：
文献类型：
--
作者：
Nishino, Takashi;Isono, Shiroh;Ishikawa, Teruhiko
本研究的目的是阐明气道刺激引起的咳嗽是否可以调节空气饥饿感。使用视觉模拟量表（VAS），我们测量了健康年轻受试者屏气断点后30 s的空气饥饿感，这些受试者在气道麻醉之前和/或之后被要求根据四种模式（自由呼吸、柠檬酸吸入、自主咳嗽和喘息）恢复呼吸。我们还测量了柠檬酸引起的咳嗽和自愿咳嗽的空气饥饿，而没有前面的屏气。屏气中断后的自由呼吸可立即缓解空气饥饿（屏气后5、15和25 s的VAS中值：39、0和0），而自主咳嗽导致空气饥饿缓解延迟枸橼酸诱导的咳嗽缓解较慢（81例，P <0.01; 49例，P <0.05; 12例，P <0.05）。相反，自发性咳嗽和柠檬酸诱导的咳嗽本身不能引起空气饥饿。吸入利多卡因气雾剂完全消除了柠檬酸吸入引起的咳嗽反应，立即缓解了空气饥饿，而气道麻醉仅轻微缓解了自愿咳嗽期间的空气饥饿。喘息期间空气饥饿的变化与气道麻醉前观察到的自主咳嗽期间的变化相似，并且不受气道麻醉的影响（麻醉前与麻醉后15 s点的VAS：18 vs 15; NS）。由气道刺激引起的咳嗽本身不会产生空气饥饿感，但可能会加重这种感觉，可能是通过迷走神经介导的机制和/或中枢机制。
The aim of this study was to clarify whether coughing elicited by airway irritation can modulate the sensation of air hunger. Using a visual analog scale (VAS), we measured air hunger for 30 s following breakpoint of a breath-hold in healthy young subjects who were asked to resume their breathing according to four patterns (free breathing, citric acid inhalation, voluntary cough, and panting) before and/or after airway anaesthesia. We also measured air hunger for citric acid-induced coughing and voluntary coughing without the preceding breath-holding. The free breathing after breakpoint of breath-holding causes an immediate relief of air hunger (VAS median values at 5, 15 and 25 s after breath-hold: 39, 0 and 0), whereas voluntary coughing causes a delay in the relief of air hunger (67, P < 0.05; 17, P < 0.05; and 0, NS) and a slower relief occurred during citric acid-induced coughing (81, P < 0.01; 49, P < 0.05; and 12, P < 0.05). Conversely, the voluntary coughing and citric acid-induced coughing per se failed to induce air hunger. Inhalation of lidocaine aerosol completely abolished the cough response to citric acid inhalation causing an immediate relief of air hunger, whereas airway anaesthesia alleviated only slightly the air hunger during voluntary coughing. The changes in air hunger during the panting were similar to those during the voluntary coughing observed before airway anaesthesia and were not affected by airway anaesthesia (VAS at 15 s point before versus after anaesthesia: 18 versus 15; NS). Coughing induced by airway irritation per se does not generate the sensation of air hunger but can aggravate it, presumably by vagally mediated mechanisms and/or central mechanisms.