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Lund-Mackay 计算机断层扫描评分与慢性咳嗽患者阻塞性肺功能变化相关。

Lund-Mackay Computed Tomography Score Is Associated With Obstructive Pulmonary Function Changes in Chronic Cough Patients.

机构信息

1 Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

2 Department of Otorhinolaryngology, International University of Health and Welfare School of Medicine, Narita, Japan.

出版信息

Am J Rhinol Allergy. 2019 May;33(3):294-301. doi: 10.1177/1945892418825094. Epub 2019 Jan 18.

Abstract

BACKGROUND

A remarkable relationship between upper airway conditions and lung diseases has been reported. At the same time, sinonasal findings in chronic cough patients have not been fully examined.

OBJECTIVE

The purpose of this study is to show paranasal sinus findings and lung function in chronic cough patients without asthma and chest X-ray abnormalities.

METHODS

A total of 1412 patients with persistent cough were enrolled in this study. Of these patients, 376 patients were evaluated for further examination, as the patients with asthma and/or chest X-ray abnormality were excluded from the study. Normal control subjects without any chronic respiratory symptoms were also recruited. Pulmonary function was examined by spirometry. A bronchial obstruction reversibility test was applied. The Lund-Mackay computed tomography (CT) score, peripheral blood eosinophil count, and immunoglobulin E concentration in serum samples were examined. The Sino-Nasal Outcome Test was used to determine the severity of clinical symptoms.

RESULTS

The patients with an abnormal soft tissue shadow in the paranasal sinus had significant obstructive lung function. The percent predicted forced expiratory volume in 1 second (FEV) and the FEV/forced vital capacity ratio negatively correlated with Lund-Mackay CT scores both before and after bronchodilator inhalation. There was a statistically significant correlation between pulmonary function and eosinophil count.

CONCLUSION

The patients with chronic cough frequently had paranasal sinus abnormalities. The Lund-Mackay CT score may be useful for assessing the condition of the lower airway in chronic cough patients. Upper airway examinations should play a part in the management of chronic cough.

摘要

背景

已有报道指出上呼吸道状况与肺部疾病之间存在显著关系。同时,慢性咳嗽患者的鼻窦情况尚未得到充分检查。

目的

本研究旨在展示无哮喘和胸部 X 线异常的慢性咳嗽患者的副鼻窦发现和肺功能。

方法

本研究共纳入 1412 例持续性咳嗽患者。其中 376 例患者进一步接受评估,因为排除了哮喘和/或胸部 X 线异常的患者。还招募了无任何慢性呼吸道症状的正常对照者。通过肺活量计检查肺功能。应用支气管扩张剂可逆性试验。检查 Lund-Mackay 计算机断层扫描(CT)评分、外周血嗜酸性粒细胞计数和血清免疫球蛋白 E 浓度。采用 Sino-Nasal Outcome Test 评估临床症状严重程度。

结果

副鼻窦软组织阴影异常的患者存在显著的阻塞性肺功能。用力呼气量占预计值的百分比(FEV)和 FEV/用力肺活量比值与支气管扩张剂吸入前后的 Lund-Mackay CT 评分呈负相关。肺功能与嗜酸性粒细胞计数之间存在显著的相关性。

结论

慢性咳嗽患者常伴有副鼻窦异常。Lund-Mackay CT 评分可能有助于评估慢性咳嗽患者下呼吸道的状况。上呼吸道检查应成为慢性咳嗽管理的一部分。

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