Cough-reflex sensitivity to inhaled capsaicin in COPD associated with increased exacerbation frequency
Cough-reflex sensitivity to inhaled capsaicin in COPD associated with increased exacerbation frequency
复制标题
COPD 患者对吸入辣椒素的咳嗽反射敏感性与加重频率增加相关
DOI：
10.1111/j.1440-1843.2009.01620.x
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发表时间：
2009
期刊：
影响因子：
6.9
通讯作者：
Mishima M
中科院分区：
文献类型：
--
作者：
Terada K;Muro S;Ohara T;Haruna A;Marumo S;Kudo M;Ogawa E;Hoshino Y;Hirai T;Niimi A;Mishima M
背景和目的：慢性阻塞性肺疾病患者病情恶化的原因尚不清楚。本研究探讨缓解期慢性阻塞性肺病患者的咳嗽反射敏感度与随后加重的频率之间的关系。方法：本研究的病例和对照的抽样框架为来医院门诊就诊的患者。使用引起5次或5次以上咳嗽的辣椒素的对数浓度(对数C5)来评估咳嗽反射敏感性。通过为期12个月的基于症状的日记前瞻性地识别随后的COPD恶化。结果：研究组包括45名COPD受试者和10名对照组。COPD组的平均LOG C50明显低于对照组(P= 0.095)。COPD组LOG C5与血清C反应蛋白水平呈负相关(r= −0.36，P= 0.0 2)，与病情加重次数呈显著正相关(r= −0.38，P= 0.0 1)。多元逐步回归分析显示咳嗽反射敏感度与咳嗽发作次数显著相关(R2= 0.15，P=0.0 1)。结论：慢性阻塞性肺疾病稳定期患者咳嗽反射对吸入辣椒素的过敏反应可能反映了呼吸道炎症反应，易加重发作。结论：慢性阻塞性肺疾病缓解期患者咳嗽反射敏感度明显高于吸入辣椒素敏感度(R2= 0.15，P=0.0 1)。
Background and objective:The causes of exacerbations in COPD patients are poorly understood. This study examined the association between cough‐reflex sensitivity in patients with stable COPD and the frequency of subsequent exacerbations.Methods:The sampling frame for cases and controls for this study was patients attending a hospital outpatient clinic. cough‐reflex sensitivity was evaluated using the log concentration of capsaicin causing five or more coughs (log C5). Subsequent COPD exacerbations were identified prospectively via symptom‐based diaries over a 12‐month period.Results:The study group comprised 45 COPD subjects and 10 controls. Mean log C5was lower in the COPD group than in the control group (0.97 (95% confidence interval (CI): 0.76–1.18) versus 1.26 (95% CI: 0.81–1.71),P= 0.095). In the COPD group, log C5was negatively correlated with serum CRP level (r= −0.36,P= 0.02) and significantly associated with the exacerbation frequency (r= −0.38,P= 0.01). Stepwise multiple regression analysis showed that cough‐reflex sensitivity was significantly associated with exacerbation frequency (r2= 0.15,P= 0.01).Conclusions:Hypersensitivity of the cough reflex to inhaled capsaicin might reflect airway inflammation in stable COPD patients, which predisposes to frequent exacerbations.