Fukuhara Atsuro, Saito Junpei, Birring Surinder S, Sato Suguru, Uematsu Manabu, Suzuki Yasuhito, Rikimaru Mami, Watanabe Natsumi, Saito Mikako, Kawamata Takaya, Umeda Takashi, Togawa Ryuichi, Sato Yuki, Koizumi Tatsuhiko, Hirai Kenichiro, Minemura Hiroyuki, Nikaido Takefumi, Kanazawa Kenya, Tanino Yoshinori, Munakata Mitsuru, Shibata Yoko
Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan.
Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan.
J Allergy Clin Immunol Pract. 2020 Feb;8(2):654-661. doi: 10.1016/j.jaip.2019.08.053. Epub 2019 Sep 18.
Cough is a frequent symptom of asthma. Cough frequency (CoFr) monitoring devices are now available to objectively measure cough counts and offer a novel endpoint to assess asthma. However, little is known about CoFr in asthma.
The aims were, first, to determine whether unique features of CoFr exist in asthmatic and nonasthmatic patients and, secondly, to evaluate relationships between CoFr and pathophysiological parameters of asthma.
In the current study, 73 asthmatic and 63 nonasthmatic patients suffering from persistent cough were enrolled. At study entry, the Leicester Cough Questionnaire (LCQ health status), cough visual analog scale (VAS), Leicester Cough Monitor (LCM), fractional exhaled nitric oxide (FeNO) measurements, and spirometry were performed. In asthmatic patients, the bronchial hyperresponsiveness (BHR) test was conducted if applicable. In 28 asthmatic and 17 nonasthmatic patients, LCQ, VAS, and LCM were examined before and after treatment.
CoFr during nighttime (asleep) was significantly higher in asthmatic patients than in nonasthmatic patients. Twenty-four-hour CoFr significantly decreased after appropriate treatment and was correlated with changes in VAS and LCQ in all patients. The improvement in cough in asthmatic patients was greater during nighttime than during daytime (awake). CoFr in asthmatic patients was significantly correlated with BHR, but not with FeNO.
In asthmatic patients, nocturnal CoFr can be associated with BHR, was significantly higher before treatment, but improved more after treatment compared with nonasthmatic patients. Monitoring nocturnal CoFr may provide unique and valuable information on making an early prediction of therapeutic effects in asthma.
咳嗽是哮喘的常见症状。现在有咳嗽频率(CoFr)监测设备可用于客观测量咳嗽次数,并提供一个评估哮喘的新终点指标。然而,关于哮喘患者的咳嗽频率知之甚少。
首先,确定哮喘患者和非哮喘患者的咳嗽频率是否存在独特特征;其次,评估咳嗽频率与哮喘病理生理参数之间的关系。
在本研究中,纳入了73例哮喘患者和63例患有持续性咳嗽的非哮喘患者。在研究开始时,进行了莱斯特咳嗽问卷(LCQ健康状况)、咳嗽视觉模拟量表(VAS)、莱斯特咳嗽监测仪(LCM)、呼出一氧化氮分数(FeNO)测量和肺功能测定。对于哮喘患者,若适用则进行支气管高反应性(BHR)测试。在28例哮喘患者和17例非哮喘患者中,在治疗前后检查了LCQ、VAS和LCM。
哮喘患者夜间(睡眠时)的咳嗽频率显著高于非哮喘患者。经过适当治疗后,24小时咳嗽频率显著降低,并且在所有患者中与VAS和LCQ的变化相关。哮喘患者夜间咳嗽的改善程度大于白天(清醒时)。哮喘患者的咳嗽频率与BHR显著相关,但与FeNO无关。
在哮喘患者中,夜间咳嗽频率可能与BHR相关,治疗前显著更高,但与非哮喘患者相比,治疗后改善更明显。监测夜间咳嗽频率可能为哮喘治疗效果的早期预测提供独特且有价值的信息。