Department of Respiratory Medicine, Hospital Universitari Germans TriasiPujol, Badalona, Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red Enfermedades Respirtorias (CIBERES), Barcelona, Spain.
Department of Pneumology, Hospital de la Santa CreuiSant Pau, Institute Sant Pau Biomedical Research (IBB Sant Pau), Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en red Enfermedades Respirtorias (CIBERES), Barcelona, Spain.
Respir Med. 2018 Feb;135:22-28. doi: 10.1016/j.rmed.2017.12.013. Epub 2018 Jan 3.
Bronchial hypersecretion is a poorly studied symptom in asthma. The aim of the study was to determine the specific characteristics of asthmatics with bronchial hypersecretion.
A total of 142 asthmatics (21.8% men; mean age 49.8 years) were prospectively followed for one year. Mucus hypersecretion was clinically classified into two severity categories: daily sputum production and frequent expectoration but not every day. Clinical and pulmonary function variables associated with mucus hypersecretion were assessed by multiple logistic regression analysis.
Daily cough was recorded in 28.9% of patients and sputum production daily or most of the days in 52.1%. Patients with mucus hypersecretion had more dyspnoea, poorer asthma control and quality of life, had suffered from more exacerbations and showed anosmia associated with chronic rhinosinusitis and nasal polyposis more frequently. Factors associated to mucus hypersecretion were anosmia, one exacerbation or more in the previous year and FEV1/FVC <70% (AUC 0.75, 95% CI 0.66-0.85) for the first definition of hypersecretion, and anosmia, poor asthma control and age (AUC 0.75, 95% CI 0.67-0.83) for the second definition.
Mucus hypersecretion is frequent in patients with asthma, and is associated with chronic upper airways disease, airway obstruction, poor asthma control and more exacerbations.
支气管过度分泌是哮喘中研究较少的症状。本研究旨在确定支气管过度分泌的哮喘患者的具体特征。
共前瞻性随访 142 名哮喘患者（21.8%为男性；平均年龄 49.8 岁）一年。通过多项逻辑回归分析评估了粘液过度分泌的临床严重程度分类（每日咳痰和频繁咳痰但非每天）与临床和肺功能变量的相关性。
28.9%的患者记录有每日咳嗽，52.1%的患者每日或多数日子有痰生成。粘液过度分泌的患者呼吸困难更严重，哮喘控制和生活质量更差，过去一年中发生过更多次加重，且伴有嗅觉丧失的慢性鼻-鼻窦炎和鼻息肉更为常见。与粘液过度分泌相关的因素包括嗅觉丧失、过去一年中发生过一次或多次加重以及 FEV1/FVC<70%（第一个过度分泌定义的 AUC 为 0.75，95%CI 为 0.66-0.85），以及嗅觉丧失、哮喘控制不佳和年龄（第二个过度分泌定义的 AUC 为 0.75，95%CI 为 0.67-0.83）。
哮喘患者中粘液过度分泌很常见，与慢性上呼吸道疾病、气道阻塞、哮喘控制不佳和更多加重有关。
