与其他纤维性间质性肺疾病相比，系统性硬化症相关间质性肺疾病患者的咳嗽症状较少见且程度较轻。

Cough is less common and less severe in systemic sclerosis-associated interstitial lung disease compared to other fibrotic interstitial lung diseases.

机构信息

Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

Centre for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada.

出版信息

Respirology. 2017 Nov;22(8):1592-1597. doi: 10.1111/resp.13084. Epub 2017 May 23.

DOI:10.1111/resp.13084

PMID:28544079

Abstract

BACKGROUND AND OBJECTIVE

The objectives of this study were to determine the prevalence and characteristics of cough in idiopathic pulmonary fibrosis (IPF), chronic hypersensitivity pneumonitis (HP) and systemic sclerosis-associated interstitial lung disease (SSc-ILD).

METHODS

Cough severity was measured in consecutive patients with IPF (n = 77), HP (n = 32) and SSc-ILD (n = 67) using a 10-cm visual analogue scale (VAS). Dyspnoea and quality of life were measured using established questionnaires. Cough severity was compared across ILD subtypes and predictors of cough severity were determined using multivariate analysis.

RESULTS

Cough was more common in IPF and chronic HP compared to SSc-ILD (87% and 83% vs 68%, P = 0.02). The median (interquartile range) VAS score was 39 (17-65) in the IPF cohort, 29 (11-48) in HP and 18 (0-33) in SSc-ILD (P < 0.0001). Cough was more often productive in chronic HP and IPF (63% and 43% vs 21%, P < 0.001). Cough severity was independently predicted only by ILD diagnosis and higher dyspnoea score. Cough severity was not associated with other common causes of cough. Cough was a significant predictor of quality of life in IPF and SSc-ILD with adjustment for age, sex, dyspnoea and ILD severity; however, cough was not associated with quality of life in chronic HP.

CONCLUSION

Cough is more frequent, more severe and more often productive in IPF and chronic HP compared to SSc-ILD, despite similar ILD severity in these cohorts. Cough severity is strongly and independently associated with dyspnoea and pulmonary function, and is a significant contributor to reduced quality of life in both IPF and SSc-ILD.

摘要

背景与目的

本研究旨在确定特发性肺纤维化（IPF）、慢性过敏性肺炎（HP）和系统性硬化症相关间质性肺病（SSc-ILD）中咳嗽的患病率和特征。

方法

采用 10cm 视觉模拟量表（VAS）对连续的 IPF（n=77）、HP（n=32）和 SSc-ILD（n=67）患者的咳嗽严重程度进行测量。采用既定问卷测量呼吸困难和生活质量。比较ILD 亚型之间的咳嗽严重程度，并采用多变量分析确定咳嗽严重程度的预测因素。

结果

与 SSc-ILD 相比，IPF 和慢性 HP 中咳嗽更为常见（87%和 83% vs 68%，P=0.02）。IPF 组 VAS 评分中位数（四分位距）为 39（17-65），HP 组为 29（11-48），SSc-ILD 组为 18（0-33）（P<0.0001）。慢性 HP 和 IPF 中咳嗽更常伴有咳痰（63%和 43% vs 21%，P<0.001）。仅ILD 诊断和更高的呼吸困难评分可独立预测咳嗽严重程度。咳嗽严重程度与其他常见咳嗽原因无关。调整年龄、性别、呼吸困难和ILD 严重程度后，咳嗽是 IPF 和 SSc-ILD 生活质量的重要预测因素；然而，在慢性 HP 中，咳嗽与生活质量无关。