Purokivi Minna, Koskela Heikki, Kontra Kirsi
Center for Medicine and Clinical Research, Division of Respiratory Medicine, Kuopio University Hospital, Kuopio, Finland.
Clin Respir J. 2013 Jul;7(3):253-60. doi: 10.1111/j.1752-699X.2012.00313.x. Epub 2012 Aug 20.
Asthma control and quality of life are poorly associated with traditional asthma biomarkers.
In the present study, we evaluated two new cough provocation tests in this respect.
Asthma Control Questionnaire and Leicester Cough Questionnaire were completed by 36 stable asthmatics. Cough provocation tests with hypertonic saline and isocapnic hyperpnoea of dry air were performed, as well as spirometry, ambulatory peak expiratory flow (PEF) monitoring and exhaled nitric oxide (eNO) measurement.
Leicester Cough Questionnaire score correlated closely with cough responsiveness to hypertonic saline and isocapnic hyperpnoea (R = -0.66, P < 0.001 and R = -0.49, P = 0.002, respectively). Asthma Control Questionnaire score also correlated with the cough responsiveness to these tests (R = 0.52, P = 0.001 and R = 0.43, P = 0.008, respectively). Forced expiratory volume in 1 s (%predicted), diurnal PEF variation and eNO did not correlate with cough-related quality of life but showed some association with asthma control. There was a significant correlation between Leicester Cough Questionnaire and Asthma Control Questionnaire (R = -0.54, P = 0.001).
Asthma control and cough-related quality of life are more closely associated with cough responsiveness to the investigated cough provocation tests than to eNO and traditional indices of bronchial obstruction. Cough is a major contributor to poor asthma control.
哮喘控制和生活质量与传统哮喘生物标志物的关联较弱。
在本研究中，我们在这方面评估了两种新的咳嗽激发试验。
36名病情稳定的哮喘患者完成了哮喘控制问卷和莱斯特咳嗽问卷。进行了高渗盐水咳嗽激发试验和等容性高通气干燥空气咳嗽激发试验，以及肺功能测定、动态呼气峰值流速（PEF）监测和呼出一氧化氮（eNO）测量。
莱斯特咳嗽问卷得分与对高渗盐水和等容性高通气的咳嗽反应性密切相关（分别为R = -0.66，P < 0.001和R = -0.49，P = 0.002）。哮喘控制问卷得分也与对这些试验的咳嗽反应性相关（分别为R = 0.52，P = 0.001和R = 0.43，P = 0.008）。第1秒用力呼气量（%预计值）、日间PEF变异率和eNO与咳嗽相关生活质量无相关性，但与哮喘控制有一定关联。莱斯特咳嗽问卷和哮喘控制问卷之间存在显著相关性（R = -0.54，P = 0.001）。
与eNO和传统支气管阻塞指标相比，哮喘控制和咳嗽相关生活质量与对所研究咳嗽激发试验的咳嗽反应性更为密切相关。咳嗽是哮喘控制不佳的主要因素。
