Hasegawa Koichi, Sato Susumu, Tanimura Kazuya, Fuseya Yoshinori, Uemasu Kiyoshi, Hamakawa Yoko, Sato Atsuyasu, Mishima Michiaki, Muro Shigeo, Hirai Toyohiro
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Respir Investig. 2018 May;56(3):230-237. doi: 10.1016/j.resinv.2018.01.001. Epub 2018 Feb 14.
Cough and sputum production (symptoms of bronchitis) are common in chronic obstructive pulmonary disease (COPD). Extrapulmonary comorbidities, such as gastroesophageal reflux disease (GERD) and post-nasal drip, also cause bronchitis symptoms. The impact of extrapulmonary comorbidities on the severity of bronchitis symptoms in COPD is unknown. The aim of this study was to quantify bronchitis symptoms and assess the impact of GERD and nasal symptoms on the severity of bronchitis symptoms in COPD.
In this cross-sectional study, stable COPD patients were recruited and completed the COPD assessment test (CAT) and Cough and Sputum Assessment Questionnaire (CASA-Q) to quantify bronchitis symptoms. To evaluate extrapulmonary comorbidities, the Frequency Scale for Symptoms of GERD (FSSG) questionnaire and nasal symptom questionnaire were completed. The impact of these comorbidities on the severity of bronchitis symptoms was analyzed.
Ninety-nine COPD patients were recruited. The presence of GERD symptoms (24.2% in the study population) was associated with more sputum symptoms. The presence of nasal discharge (43.4%) was associated with more cough and sputum symptoms, whereas post-nasal drip (13.1%) was associated with more sputum symptoms. On multivariate analyses, nasal discharge was associated with more cough symptoms. GERD and post-nasal drip were associated with more sputum symptoms.
This study showed that the presence of GERD and/or nasal symptoms is associated with an increase in bronchitis symptoms. Careful assessment of extrapulmonary comorbidities is necessary in the evaluation of bronchitis symptoms in COPD patients.
咳嗽和咳痰（支气管炎症状）在慢性阻塞性肺疾病（COPD）中很常见。肺外合并症，如胃食管反流病（GERD）和鼻后滴漏，也会导致支气管炎症状。肺外合并症对COPD患者支气管炎症状严重程度的影响尚不清楚。本研究的目的是量化支气管炎症状，并评估GERD和鼻部症状对COPD患者支气管炎症状严重程度的影响。
在这项横断面研究中，招募了稳定期COPD患者，并完成慢性阻塞性肺疾病评估测试（CAT）和咳嗽与痰液评估问卷（CASA-Q）以量化支气管炎症状。为评估肺外合并症，完成了胃食管反流病症状频率量表（FSSG）问卷和鼻部症状问卷。分析了这些合并症对支气管炎症状严重程度的影响。
招募了99名COPD患者。GERD症状的存在（研究人群中为24.2%）与更多的痰液症状相关。流涕（43.4%）的存在与更多的咳嗽和痰液症状相关，而鼻后滴漏（13.1%）与更多的痰液症状相关。多因素分析显示，流涕与更多的咳嗽症状相关。GERD和鼻后滴漏与更多的痰液症状相关。
本研究表明，GERD和/或鼻部症状的存在与支气管炎症状增加相关。在评估COPD患者的支气管炎症状时，有必要仔细评估肺外合并症。
