Guglielminotti Jean, Tesniere Antoine, Rackelboom Thibaut, Mantz Jean, Vecchierini Marie-Françoise, Bonay Marcel, Marmuse Jean-Pierre, Montravers Philippe, Desmonts Jean-Marie
Département d'Anesthésie et de Réanimation Chirurgicale, Hôpital Bichat, Assistance Publique - Hôpitaux de Paris, 46 rue Henri Huchard, 75018 Paris, France.
Respir Physiol Neurobiol. 2007 Aug 15;158(1):83-7. doi: 10.1016/j.resp.2007.02.019. Epub 2007 Mar 2.
Obstructive sleep apnea (OSA) is associated with impaired airway reflexes. Cough is the main airway defense mechanism but the effect of OSA on cough is unknown. Thirty-two female obese patients scheduled to undergo bariatric surgery were studied. They were classified as presenting OSA (20 patients) when the apnea-hypopnea index (AHI) was greater than 5h. Cough sensitivity was measured with citric acid. Increasing concentrations of nebulized citric acid were delivered until cough was elicited. The concentrations eliciting one (C1) and two coughs (C2) were recorded and log transformed (log C1 and log C2). log C1 and log C2 (median (interquartile)) were 1.90 mg/mL (0.90) and 2.2mg/mL (0.30) in OSA patients and 1.60 mg/mL (0.45) and 1.60 mg/mL (0.45) in non-OSA patients, respectively (comparison between groups: p=0.0372 for log C1 and p=0.0227 for log C2). A significant relationship was observed between AHI and log C1 and log C2. Cough sensitivity is therefore, decreased in female obese OSA patients and this decreased sensitivity is positively correlated with disease severity.
阻塞性睡眠呼吸暂停（OSA）与气道反射受损有关。咳嗽是主要的气道防御机制，但OSA对咳嗽的影响尚不清楚。对32名计划接受减肥手术的肥胖女性患者进行了研究。当呼吸暂停低通气指数（AHI）大于5次/小时时，她们被归类为患有OSA（20名患者）。用柠檬酸测量咳嗽敏感性。给予雾化柠檬酸的浓度逐渐增加，直到引发咳嗽。记录引发一次咳嗽（C1）和两次咳嗽（C2）的浓度，并进行对数转换（log C1和log C2）。OSA患者的log C1和log C2（中位数（四分位间距））分别为1.90mg/mL（0.90）和2.2mg/mL（0.30），非OSA患者分别为1.60mg/mL（0.45）和1.60mg/mL（0.45）（组间比较：log C1为p = 0.0372，log C2为p = 0.0227）。观察到AHI与log C1和log C2之间存在显著关系。因此，肥胖女性OSA患者的咳嗽敏感性降低，且这种敏感性降低与疾病严重程度呈正相关。
