上气道咳嗽综合征的咳嗽敏感性改变及其意义

Changes and implications of cough sensitivity in upper airway cough syndrome

关键词:  上气道咳嗽综合征  慢性咳嗽  咳嗽敏感性  辣椒素

Key words:  upper airwaycough syndrome  chronic cough  cough sensitivity  capsaicin

摘要:

目的 探讨上气道咳嗽综合征咳嗽敏感性的改变和临床意义。方法 用辣椒素咳嗽敏感性试验检测94例上气道咳嗽综合征的咳嗽阈值C5,分析治疗后咳嗽阈值C5的改变。结果 94例上气道咳嗽综合征的辣椒素咳嗽阚值C5为3.9 (0.98,7.8)μmol/L,位于正常值范围,仅36例(36/94,38.30％)患者存在咳嗽高敏感性。经治疗咳嗽症状消失后30例患者接受了随访复查,治疗前辣椒素咳嗽阈值C5为5.85 (1.95,31.2) μmol/L,与治疗后的7.8 (0.98,7.8) μmol/L相比,差别无统计学意义(Z=-0.72,P=0.47).其中12例治疗前咳嗽敏感性增高者中有6例降至正常。结论 上气道咳嗽综合征的咳嗽敏感性存在不均一性,与正常值存在较大的重叠和交叉,大部分不符合咳嗽高敏感性综合征的概念。

Abstract:

Objective To investigate the changes and clinical implications of cough sensitivity in upper airway cough syndrome(UACS).Methods Cough threshold C5 was measured by capsaicin cough sensitivity test in 94 patients with upper airway cough syndrome;it was also measured in 30 patients after cough completely resolved with specific therapy.Results The mean cough threshold C5 was 5.85(1.95,31.2)μmol/L and within the normal range;however,36 patients(38.30%) presented cough hypersensitivity.Thirty patients received re-examination of cough sensitivity to capsaicin after cough disappeared,there was no significant difference in cough threshold C5 between pre-and post-treatment[5.85(1.95,31.2)μmol/L vs 7.8(0.98,7.8)μmol/L,Z=-0.72,P= 0.47].The effective treatment resulted in the recover of cough threshold C5 to normal level in 6 of 12 patients with increased cough sensitivity to capsaicin.Conclusion Cough sensitivity in upper airway cough syndrome is heterogeneous and overlapped with normal value.Therefore,upper airway cough syndrome is not always consistent with the concept of cough hypersensitivity syndrome.