Dicpinigaitis P V, Grimm D R, Lesser M
Department of Medicine, Albert Einstein College of Medicine, and the Spinal Cord Pulmonary Research Center, Veterans Affairs Medical Center, Bronx, NY, USA.
Arch Phys Med Rehabil. 2000 Jul;81(7):921-3. doi: 10.1053/apmr.2000.5612.
To determine the effect of the GABA-agonist baclofen on cough reflex sensitivity in subjects with cervical spinal cord injury (C-SCI). Baclofen has been shown to inhibit the cough reflex in able-bodied volunteers.
Prospective, nonrandomized control trial.
Veterans Affairs medical center with large outpatient SCI population.
Twelve adult males (11 outpatients) with C-SCI chronically maintained on oral baclofen for the treatment of muscle spasm.
Subjects underwent cough challenge testing with inhaled capsaicin. The concentrations (microM) of capsaicin inducing 2 or more (C2) and 5 or more (C5) coughs were determined. Mean values for log C2 and log C5 were compared with a control group of outpatients with C-SCI not receiving baclofen.
Subjects treated with baclofen had a significantly higher cough threshold (diminished cough reflex sensitivity) than control subjects. Mean (+/- standard error of the mean) values for log C2 in study subjects and controls were 1.28 +/- .16 and .65 +/- .15, respectively (p = .009). Mean values for log C5 in subjects receiving baclofen and in control subjects were 2.20 +/- .22 and 1.43 +/- .23, respectively (p = .024). Subjects and controls did not differ in terms of age, spirometric parameters, or duration of injury.
The results suggest that chronic therapy with baclofen diminishes cough reflex sensitivity in subjects with C-SCI. The clinical significance of this finding remains to be elucidated.
确定γ-氨基丁酸（GABA）激动剂巴氯芬对颈脊髓损伤（C-SCI）患者咳嗽反射敏感性的影响。巴氯芬已被证明可抑制健康志愿者的咳嗽反射。
前瞻性、非随机对照试验。
拥有大量脊髓损伤门诊患者的退伍军人事务医疗中心。
12名成年男性（11名门诊患者），患有C-SCI，长期口服巴氯芬以治疗肌肉痉挛。
受试者接受吸入辣椒素的咳嗽激发试验。确定诱发2次或更多次（C2）和5次或更多次（C5）咳嗽的辣椒素浓度（微摩尔）。将log C2和log C5的平均值与未接受巴氯芬治疗的C-SCI门诊对照组进行比较。
接受巴氯芬治疗的受试者咳嗽阈值显著高于对照组（咳嗽反射敏感性降低）。研究对象和对照组log C2的平均值（±平均标准误差）分别为1.28±0.16和0.65±0.15（p = 0.009）。接受巴氯芬治疗的受试者和对照组log C5的平均值分别为2.20±0.22和1.43±0.23（p = 0.024）。受试者和对照组在年龄、肺功能参数或损伤持续时间方面无差异。
结果表明，巴氯芬长期治疗可降低C-SCI患者的咳嗽反射敏感性。这一发现的临床意义尚待阐明。
