Doğru Gonca, Balkarli Ayşe, Dogru Atalay
Department of Chest Diseases, Isparta State Hospital, Isparta, Turkey.
Department of Internal Medicine, Antalya Training and Research Hospital, Division of Rheumatology, Antalya, Turkey.
Arch Rheumatol. 2017 Apr 5;32(4):303-308. doi: 10.5606/ArchRheumatol.2017.6160. eCollection 2017 Dec.
This study aims to evaluate the frequency of chronic cough due to dryness in the trachea and the relationship between depression and chronic cough in patients with primary Sjögren's syndrome (pSS).
Eighty non-smoking patients (7 males, 73 females; mean age 47.6±9.2 years; range 18 to 70 years) with newly diagnosed pSS were included. All patients were evaluated clinically, radiologically, and physiologically. Patients with cough were assessed using the Leicester Cough Questionnaire and visual analog scale. Beck Depression Inventory was used to determine the risk of depression in patients with cough. Patients with asthma, rhinosinusitis, gastrooesophageal reflux, and drug use which cause cough and pulmonary involvement in pSS were excluded.
Non-productive cough was detected in 30 patients (37.5%). Fourteen patients (17.5%) were admitted to the hospital with cough at least once before the diagnosis of pSS. The median time between onset of symptoms and firm diagnosis was 24 months (25-75 interquartile ranges: 3-60 months). A significant difference was observed in the Beck Depression Inventory scores between patients with and without cough. There was a significant negative relationship between Leicester Cough Questionnaire and Beck Depression Inventory scores.
Patients with pSS often have symptoms for a long duration that mimic those of more commonly encountered non-specific pulmonary conditions. Xerotrachea should be considered in the differential diagnosis of chronic cough, especially in patients with normal pulmonary function tests and pulmonary imaging.
本研究旨在评估原发性干燥综合征(pSS)患者气管干燥所致慢性咳嗽的发生率以及抑郁与慢性咳嗽之间的关系。
纳入80例新诊断为pSS的非吸烟患者(7例男性,73例女性;平均年龄47.6±9.2岁;范围18至70岁)。所有患者均进行了临床、影像学和生理学评估。对咳嗽患者使用莱斯特咳嗽问卷和视觉模拟量表进行评估。采用贝克抑郁量表确定咳嗽患者的抑郁风险。排除患有哮喘、鼻窦炎、胃食管反流以及因使用药物导致咳嗽和pSS肺部受累的患者。
30例患者(37.5%)检测到干咳。14例患者(17.5%)在pSS诊断前至少因咳嗽住院一次。症状出现至确诊的中位时间为24个月(四分位间距25 - 75:3 - 60个月)。咳嗽患者与未咳嗽患者的贝克抑郁量表评分存在显著差异。莱斯特咳嗽问卷评分与贝克抑郁量表评分之间存在显著负相关。
pSS患者常有长时间类似更常见非特异性肺部疾病的症状。在慢性咳嗽的鉴别诊断中应考虑气管干燥,尤其是肺功能检查和肺部影像学正常的患者。