Centre for Inflammation Research, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
Respir Med. 2013 Jul;107(7):1008-13. doi: 10.1016/j.rmed.2013.04.006. Epub 2013 May 15.
We have explored the association of the upper airway symptoms related to cough with exacerbation frequency, sputum microbiology and inflammatory markers in patients with non cystic fibrosis bronchiectasis.
Patients with bronchiectasis completed the Hull Airway Reflux Questionnaire (HARQ). A score of >13 was taken to indicate the presence of reflux. Patients were followed-up with longitudinal spirometry, sputum culture and Leicester cough questionnaire (LCQ). Myeloperoxidase (MPO), free neutrophil elastase (NE) activity, Interleukin (IL)-8 and Tumour Necrosis Factor (TNF)-α was measured from spontaneous sputum samples.
163 completed the study. 59.5% were female. Mean age was 65.7 years. 73.6% reported airway reflux using HARQ. Patients with airway reflux had more severe cough symptoms as assessed by the LCQ [15.2 (3.5) vs. 19.4 (1.9)], p < 0.001. Sputum levels of MPO, NE, IL-8 and TNF-α were all significantly higher in the reflux positive group (p < 0.05 for all comparisons). In a multivariable logistic regression, airway reflux was independently associated with cough severity (-3.27, standard error 0.81, p = 0.0002). Airway reflux, age, FEV1 % predicted and colonization with Pseudomonas aeruginosa were independently associated with an increased risk of ≥3 bronchiectasis exacerbations in one year.
The symptoms of airway reflux independently predict severity and exacerbation frequency in non cystic fibrosis bronchiectasis.
我们探讨了与咳嗽相关的上呼吸道症状与非囊性纤维化支气管扩张症患者的加重频率、痰微生物学和炎症标志物之间的关系。
支气管扩张症患者完成了赫尔气道反流问卷（HARQ）。评分>13 表明存在反流。对患者进行纵向肺活量测定、痰培养和莱斯特咳嗽问卷（LCQ）随访。从自发性痰标本中测量髓过氧化物酶（MPO）、游离中性粒细胞弹性蛋白酶（NE）活性、白细胞介素（IL）-8 和肿瘤坏死因子（TNF）-α。
163 例完成了研究。59.5%为女性。平均年龄为 65.7 岁。73.6%的患者使用 HARQ 报告气道反流。通过 LCQ 评估，气道反流患者的咳嗽症状更严重[15.2（3.5）比 19.4（1.9）]，p<0.001。在反流阳性组中，痰 MPO、NE、IL-8 和 TNF-α 水平均显著升高（所有比较 p<0.05）。在多变量逻辑回归中，气道反流与咳嗽严重程度独立相关（-3.27，标准误差 0.81，p=0.0002）。气道反流、年龄、FEV1%预计值和铜绿假单胞菌定植与一年内≥3 次支气管扩张症加重的风险增加独立相关。
气道反流的症状独立预测非囊性纤维化支气管扩张症的严重程度和加重频率。
