Effect of iron supplementation in women with chronic cough and iron deficiency
Effect of iron supplementation in women with chronic cough and iron deficiency
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DOI：
10.1111/ijcp.12001
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发表时间：
2012-11-01
影响因子：
2.6
通讯作者：
Rolla, G.
中科院分区：
文献类型：
--
作者：
Bucca, C.;Culla, B.;Rolla, G.
目的：女性慢性咳嗽比男性更频繁和严重。女性通常由于月经和怀孕而减少铁储存。我们研究了铁缺乏是否通过增加气道对吸入刺激物的敏感性而在慢性咳嗽中发挥作用。研究方法：对22例慢性不明原因咳嗽伴铁缺乏（血清铁蛋白<15 ng/ml）的非吸烟女性患者，分别于基线、抗H1-组胺药和质子泵抑制剂经验性治疗2个月后及补铁（硫酸铁片330660 mg/d）2个月后进行检测。结果测量为咳嗽视觉模拟量表（VAS），喉（PC 25 MIF 50，浓度引起25%的MIF 50），支气管（PC 20 FEV 1）和咳嗽（PC 5cough）的组胺阈值。结果：血清铁蛋白平均值为9.3ng/ml（95% CI为7.710.9），13例有轻度贫血。所有患者均有喉和咳嗽高反应性，12例伴有支气管高反应性。经验性治疗没有产生显著效果，而补铁改善了咳嗽VAS，从4.03（3.64.47）至2.6（1.93.27），p < 0.0001，PC 20 FEV 1从10.04 mg/ml（5.3718.77）至22.2（11.741.8），p < 0.001，PC 25 MIF 50从3.09 mg/ml（1.94.9）至11.9（7.319.4），p < 0.001，PC 5咳嗽从2.1 mg/ml（1.23.6）至8.8（5.215.1），p < 0.001。结论：在对靶向治疗无反应的不明原因慢性咳嗽的女性中，气道和咳嗽高反应性可能因缺铁而持续。患有慢性咳嗽的健康女性应检查是否缺铁，因为铁补充可能会解决这种令人不安的症状。
Aims: Chronic cough is more frequent and severe in women than in men. Women often have decreased iron stores, because of menses and pregnancies. We investigated if iron deficiency has a role in chronic cough by increasing airway sensitivity to inhaled irritants. Methods: Twenty-two non-smoking women with chronic unexplained cough and iron deficiency (serum ferritin below 15 ng/ml) were examined in baseline, after 2 months empiric treatment with anti H1-histaminic drug and proton pump inhibitor, and after iron supplementation (330660 mg iron sulphate tablets daily) for 2 months. Outcome measures were cough visual analogue scale (VAS), and histamine thresholds of the larynx (PC25MIF50, concentration causing 25% in MIF50), bronchi (PC20FEV1) and cough (PC5cough). Results: Mean serum ferritin was 9.3 ng/ml (95% CI 7.710.9), 13 patients had mild anaemia. All the patients had laryngeal and cough hyperresponsiveness,12 had also bronchial hyperresponsiveness. Empiric treatment produced no significant effect, whereas iron supplementation improved cough VAS from 4.03 (3.64.47) to 2.6 (1.93.27), p < 0.0001, PC20FEV1 from 10.04 mg/ml (5.3718.77) to 22.2 (11.741.8), p < 0.001, PC25MIF50 from 3.09 mg/ml (1.94.9) to 11.9 (7.319.4), p < 0.001 and PC5cough from 2.1 mg/ml (1.23.6) to 8.8 (5.215.1), p < 0.001. Conclusion: In women with unexplained chronic cough unresponsive to targeted treatment, airway and cough hyperresponsiveness may be sustained by iron deficiency. Healthy women with chronic cough should be checked for iron deficiency as iron repletion may resolve such disturbing symptom.