Chronic Cough in Individuals With COPD A Population-Based Cohort Study
Chronic Cough in Individuals With COPD A Population-Based Cohort Study
复制标题
慢性阻塞性肺疾病患者慢性咳嗽的人群队列研究
DOI：
10.1016/j.chest.2019.12.038
复制
发表时间：
2020-06-01
期刊：
影响因子：
9.6
通讯作者：
Dahl, Morten
中科院分区：
文献类型：
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作者：
Landt, Eskild;Colak, Yunus;Dahl, Morten
背景：慢性咳嗽在慢性阻塞性肺病患者中的作用和影响尚未在普通人群中得到描述。本研究假设共病性慢性咳嗽是COPD患者疾病严重程度的标志。方法：本研究确定了患有慢性阻塞性肺病和慢性咳嗽的个体，并记录了来自哥本哈根普通人群研究（CGPS）的43271名成年人的呼吸系统症状、医疗保健利用、肺功能和血液中的炎症生物标志物。结果：在43271名普通人群中，8181名（19%）患有COPD，其中796名（10%）患有慢性咳嗽。COPD合并慢性咳嗽患者的莱斯特咳嗽问卷中位数（25 -75百分位）总分为17.7分（16.0-18.9分），生理领域为5.9分（5.3-6.3分），心理领域为5.6分（4.9-6.3分），社会领域为6.3分（5.8-6.8分）。在慢性阻塞性肺病患者中，慢性咳嗽患者比非慢性咳嗽患者更常出现咳痰（60%比8%）、喘息（46%比14%）、呼吸困难（66%比38%）、胸痛/胸闷（9%比4%）、夜间呼吸困难（8%比3%）、过去10年急性支气管炎/肺炎发作（45%比25%），以及过去12个月内>= 3次全科医生就诊（53%比37%）。此外，这些个体的FEV1预测值（81% vs 89%）和FEV1/FVC （0.64 vs 0.66）较低，血液中高敏c反应蛋白、纤维蛋白原、白细胞、中性粒细胞、嗜酸性粒细胞和IgE水平较高。结论：COPD患者的合并症慢性咳嗽与更严重的疾病相关，包括更多的呼吸道症状和医疗保健利用、肺功能降低和血液炎症增加。
BACKGROUND: The role and impact of chronic cough in individuals with COPD have not been described in the general population. This study hypothesized that comorbid chronic cough is a marker of disease severity in individuals with COPD.METHODS: This study identified individuals with COPD and chronic cough, and recorded respiratory symptoms, health-care utilizations, lung function, and inflammatory biomarkers in blood in a nested cohort of 43,271 adults from the Copenhagen General Population Study (CGPS).RESULTS: Among 43,271 individuals from the general population, 8,181 (19%) experienced COPD, of whom 796 (10%) had chronic cough. Individuals with COPD and chronic cough had a Leicester Cough Questionnaire median (25th-75th percentiles) total score of 17.7 (16.0-18.9), corresponding to 5.9 (5.3-6.3) for the physical domain, 5.6 (4.9-6.3) for the psychological domain, and 6.3 (5.8-6.8) for the social domain. Among individuals with COPD, those with chronic cough vs those without chronic cough more often experienced sputum production (60% vs 8%), wheezing (46% vs 14%), dyspnea (66% vs 38%), chest pain/tightness (9% vs 4%), nighttime dyspnea (8% vs 3%), episodes of acute bronchitis/pneumonias in the last 10 years (45% vs 25%), and >= 3 general practitioner visits in the past 12 months (53% vs 37%). Furthermore, these individuals had lower FEV1 % predicted (81% vs 89%) and FEV1/FVC (0.64 vs 0.66), as well as higher levels of high-sensitivity C-reactive protein, fibrinogen, leukocytes, neutrophils, eosinophils, and IgE in blood.CONCLUSIONS: Comorbid chronic cough in individuals with COPD is associated with a more severe disease in terms of more respiratory symptoms and health-care utilizations, lower lung function, and increased inflammation in blood.