Features of cough variant asthma and classic asthma during methacholine-induced brochoconstriction: a cross-sectional study.
Features of cough variant asthma and classic asthma during methacholine-induced brochoconstriction: a cross-sectional study.
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DOI：
10.1186/1745-9974-5-3
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发表时间：
2009-03-09
期刊：
影响因子：
--
通讯作者：
Mishima M
中科院分区：
文献类型：
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作者：
Matsumoto H;Niimi A;Takemura M;Ueda T;Yamaguchi M;Matsuoka H;Jinnai M;Chin K;Mishima M
咳嗽变异性哮喘（CVA）与经典哮喘之间的机制和表型差异知之甚少，前者表现为慢性咳嗽，是对支气管扩张剂有反应的唯一症状，后者在乙酰甲胆碱吸入过程中伴有喘息。在这里，我们报告了气道敏感性，气道反应性，并作为主要关注，咳嗽和喘息的出现在乙酰甲胆碱吸入CVA或经典哮喘患者。我们横断面检查了未接受过激素治疗的典型哮喘（n = 58）或CVA（n = 55）成人患者在持续吸入乙酰甲胆碱的同时测量呼吸阻力时的气道敏感度、阻力开始增加的点、反应性、乙酰甲胆碱阻力曲线的斜率以及咳嗽和喘息的出现。CVA患者对吸入乙酰甲胆碱的敏感性和反应性较低，在乙酰甲胆碱诱导的支气管收缩过程中，喘息频率较低，但咳嗽频率高于经典哮喘患者。多变量分析显示，气道过敏和较低的基线FEV 1/FVC与喘息的出现相关，而CVA的诊断与咳嗽相关。CVA与经典哮喘在乙酰甲胆碱吸入过程中存在机制和表型差异。在支气管收缩期间频繁咳嗽可能是CVA的显著特征。
Little is known regarding mechanistic and phenotypic differences between cough variant asthma (CVA), presenting with a chronic cough as the sole symptom that responds to bronchodilators, and classic asthma with wheezing during methacholine inhalation. Here we reported airway sensitivity, airway reactivity, and as the main concern, the appearance of cough and wheezes during methacholine inhalation in patients with CVA or classic asthma. We cross-sectionally examined the degrees of airway sensitivity, the point where resistance started to increase, and reactivity, the slope of the methacholine-resistance curve, and the appearance of cough and wheezes in steroid-naïve adult patients with classic asthma (n = 58) or CVA (n = 55) while they were continuously inhaling methacholine during simultaneous measurement of respiratory resistance. Patients with CVA were less sensitive and less reactive to inhaled methacholine and wheezed less frequently but coughed more frequently during methacholine-induced bronchoconstriction than did patients with classic asthma. Multivariate analysis revealed that airway hypersensitivity and lower baseline FEV1/FVC were associated with the appearance of wheezes, whereas a diagnosis of CVA was associated with coughing. There are mechanistic and phenotypic differences between CVA and classic asthma during methacholine inhalation. Frequent coughing during bronchoconstriction may be a distinctive feature of CVA.