Plevková J, Tatár M
Ustav patologickej fyziológie, Jesseniova lekárska fakulta UK v Martine.
Cesk Fysiol. 2004;53(4):152-8.
Mechanisms responsible for coughing in patients with rhinitis are not completely elucidated, because afferent innervation of nasal mucosa is not able to mediate cough reflex. There are several mechanisms that can participate in this pathogenetic process. The group of these mechanisms include: postnasal dripping of nasal mucus into the larynx, complete obstruction of the nasal cavity with inappropriate air conditioning, incomplete obstruction of nasal cavity with a possibility of microaspiration of nasal exudate, nasobronchial reflex, facilitating interaction between afferent inputs from nasal mucosa and central neuronal network responsible for coughing or propagation of the inflammatory process from the nose via airways or via systemic circulation into the lower airways mucosa. The most important mechanism that should be taken into consideration is hightened cough sensitivity (decreased threshold of afferent nerve endings in the larynx, trachea and more peripheral airways mediating cough) due to different effects of mechanisms mentioned above on the structure and/or function of afferent nerve endings in the lower airways responsible for inception and modulation of the cough reflex.
鼻炎患者咳嗽的机制尚未完全阐明,因为鼻黏膜的传入神经支配无法介导咳嗽反射。有几种机制可参与这一发病过程。这些机制包括:鼻腔黏液向后滴入喉部、鼻腔完全阻塞伴不适当的空气调节、鼻腔不完全阻塞伴鼻腔分泌物微吸入的可能性、鼻支气管反射、促进来自鼻黏膜的传入输入与负责咳嗽的中枢神经网络之间的相互作用,或炎症过程从鼻腔经气道或经体循环传播至下呼吸道黏膜。应考虑的最重要机制是由于上述机制对下呼吸道负责启动和调节咳嗽反射的传入神经末梢的结构和/或功能的不同影响,导致咳嗽敏感性增加(介导咳嗽的喉、气管和更外周气道的传入神经末梢阈值降低)。