A comparison of objective and subjective measures of cough in asthma
A comparison of objective and subjective measures of cough in asthma
复制标题
DOI：
10.1016/j.jaci.2008.08.029
复制
发表时间：
2008-11-01
影响因子：
14.2
通讯作者：
Woodcock, Ashley A.
中科院分区：
文献类型：
--
作者：
Marsden, Paul A.;Smith, Jaclyn A.;Woodcock, Ashley A.
背景：咳嗽被广泛认为是哮喘诊断和监测的关键症状，但人们对如何最好地评估哮喘的咳嗽知之甚少。目的：确定哮喘患者的客观咳嗽频率与主观咳嗽指标的相关性。方法：我们研究了56例哮喘患者，中位年龄42.0岁(范围28.5-71岁)，女性34例(60.7%)。受试者进行咳嗽反射敏感性测试(导致2次和5次咳嗽的柠檬酸浓度[C2和C5])，24小时全动态咳嗽记录，主观评分咳嗽严重程度(视觉模拟评分和0~5分)，并完成咳嗽相关生活质量问卷(莱斯特咳嗽问卷)。结果：咳嗽时间的中位数为2.6cs/h(范围为0.0-14.2)，受试者白天咳嗽的时间中位数为3.9cs/h[0.0-18.5]，高于夜间咳嗽时间的中位数(0.3cs/h[0.0-8.7]；P<；.001)。日间咳嗽发生率与log(10)C2呈弱负相关(r=-0.39；P=0.03)，而与log(10)C5无关(r=4.08；P=0.65)。咳嗽时间与主观咳嗽评分和视觉模拟评分呈弱-中度相关，与咳嗽相关生活质量的相关性最强(r=-0.54；P<；.001)。结论：咳嗽和咳嗽反射敏感度的主观测量不能很好地替代哮喘患者的客观咳嗽频率。在设计评估哮喘咳嗽干预措施的研究时，我们主张将咳嗽的客观测量和咳嗽相关的生活质量结合起来。(《过敏与免疫》杂志2008；122：903-7。)
Background: Cough is widely recognized as a key symptom in the diagnosis and the monitoring of asthma, but little is known about how best to assess cough in asthma.Objective: To determine how objective cough rates correlate with subjective measures of cough in asthma. Methods: We studied 56 subjects, median age 42.0 years (range, 28.5-71), 34 (60.7%) female, with asthma. Subjects performed cough reflex sensitivity testing (concentration of citric acid causing 2 and 5 coughs [C2 and C5]), 24-hour fully ambulatory cough recordings, subjectively scored the severity of their cough (visual analog scales and 0-5 score) and completed a cough-related quality of life questionnaire (Leicester Cough Questionnaire). Ambulatory cough recordings were manually counted and reported in cough seconds per hour (cs/h).Results: The median time spent coughing was 2.6 cs/h (range, 0.0-14.2), with subjects spending more time coughing by day (median, 3.9 cs/h [0.0-18.5]) than by night (median, 0.3 cs/h [0.0-8.7]; P < .001). A weak inverse relationship was seen between day cough rates and log(10)C2 (r = -0.39; P = .03) but not log(10)C5 (r = 4.08; P = .65). Objective time spent coughing was also weak-moderately associated with subjective cough scores and visual analog scales, and most strongly correlated with cough-related quality of life (r = -0.54; P < .001).Conclusion: Subjective measures of cough and cough reflex sensitivity are poor surrogates for objective cough frequency in asthma. When designing studies to assess interventions for cough in asthma, we advocate a combination of both objective measures of cough and cough-related quality of life. (J Allergy Clin Immunol 2008;122:903-7.)