Lätti Anne M, Pekkanen Juha, Koskela Heikki O
Unit for Medicine and Clinical Research, Pulmonary Division, Kuopio University Hospital, Kuopio, Finland.
School of Medicine, Institute of Clinical Sciences, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
ERJ Open Res. 2020 May 26;6(2). doi: 10.1183/23120541.00229-2019. eCollection 2020 Apr.
Chronic cough causes significant impairment in the quality of life and is often immune to treatment. Previous studies about its persistence have focused on patients managed in special cough clinics. Little is known about the persistence of chronic cough in unselected populations. In this prospective follow-up study, we investigated factors that predict the persistence of cough at 12-month follow-up in a community-based study of subjects with chronic cough. The first e-mail survey in 2017 included a questionnaire about current cough and its risk factors. The 264 subjects who reported chronic cough were sent a follow-up questionnaire 12 months later. The response rate was 77.7% (205 subjects), of whom 165 subjects (80.5%) still had cough in 2018. In multivariate analysis, the following baseline factors predicted the persistence of cough at 12 months; gastro-oesophageal reflux disease (adjusted OR (aOR) 5.02 (95% CI 1.10-22.83)), presence of a chemical trigger (aOR 2.88 (95% CI (1.20-7.00)), duration of cough more than 1 year (aOR 2.80 (95% CI 1.27-6.22)), frequent somatic symptoms (aOR 1.31 (95% CI 1.07-1.59)), and low number of family members (aOR 0.71 (95% CI 0.52-0.98)). In conclusion, most patients with chronic cough still suffer from cough 1 year later. The presence of gastro-oesophageal reflux disease is the main predictor for the persistence of cough.
慢性咳嗽会严重损害生活质量，且往往对治疗无反应。以往关于慢性咳嗽持续存在的研究主要集中在特殊咳嗽诊所的患者。对于未经过筛选的人群中慢性咳嗽的持续情况知之甚少。在这项前瞻性随访研究中，我们在一项基于社区的慢性咳嗽患者研究中，调查了在12个月随访时预测咳嗽持续存在的因素。2017年的首次电子邮件调查包括一份关于当前咳嗽及其危险因素的问卷。264名报告有慢性咳嗽的受试者在12个月后收到一份随访问卷。应答率为77.7%（205名受试者），其中165名受试者（80.5%）在2018年仍有咳嗽。在多变量分析中，以下基线因素可预测12个月时咳嗽的持续存在；胃食管反流病（调整后的比值比（aOR）5.02（95%可信区间1.10 - 22.83））、存在化学触发因素（aOR 2.88（95%可信区间（1.20 - 7.00））、咳嗽持续时间超过1年（aOR 2.80（95%可信区间1.27 - 6.22））、频繁的躯体症状（aOR 1.31（95%可信区间1.07 - 1.59））以及家庭成员数量少（aOR 0.71（95%可信区间0.52 - 0.98））。总之，大多数慢性咳嗽患者在1年后仍受咳嗽困扰。胃食管反流病的存在是咳嗽持续存在的主要预测因素。
