From the Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China.
National Health and Medical Research Council Centre for Research Excellence in Severe Asthma and Treatable Traits, The University of Newcastle, Newcastle, New South Wales, Australia.
Allergy Asthma Proc. 2022 May 1;43(3):209-219. doi: 10.2500/aap.2022.43.220022.
Cough is often the most prominent and intractable symptom reported by patients with asthma, but few studies have explored the characteristics of patients with asthma and with chronic cough (CC) in a real-world setting. In a prospective cohort study, patients ages ≥ 18 years with stable asthma were consecutively recruited at the West China Hospital, Sichuan University. The patients were classified as having asthma with CC (the CC group) or asthma with non-CC (the non-CC group) after 3 months of optimized asthma therapy according to standard guidelines. Multidimensional assessment was performed at baseline, followed by a 12-month follow-up to assess asthma exacerbations. Of 323 patients with asthma, 127 patients were assigned to the CC group and 196 patients were assigned to the non-CC group. The participants with CC were older and had more airflow obstruction; worse asthma control and quality of life; increased airway inflammation; upper respiratory tract infection as a trigger; and more comorbidities, such as psychological dysfunction, rhinitis, chronic obstructive pulmonary disease, and bronchiectasis. They reported greater work productivity loss and daily activity impairment, and increased moderate-to-severe exacerbations. The participants with asthma and with CC had a significant disease burden, with increased exacerbations, health-care utilization, and impaired work productivity and daily activity. These observations indicated potential clinical implications in patients with asthma and with CC, and call for more attention to this aspect of asthma.
咳嗽是哮喘患者最常见且难以控制的症状，但很少有研究在真实环境中探讨哮喘患者和慢性咳嗽（CC）患者的特征。在一项前瞻性队列研究中，连续招募了年龄≥18 岁、病情稳定的哮喘患者，他们在四川大学华西医院就诊。根据标准指南，经过 3 个月的优化哮喘治疗后，患者被分为哮喘伴 CC（CC 组）或哮喘不伴 CC（非 CC 组）。在基线时进行多维评估，然后进行 12 个月的随访，以评估哮喘恶化情况。在 323 名哮喘患者中，127 名患者被分配到 CC 组，196 名患者被分配到非 CC 组。CC 组患者年龄较大，气流阻塞更严重；哮喘控制和生活质量更差；气道炎症增加；上呼吸道感染作为触发因素；合并症更多，如心理功能障碍、鼻炎、慢性阻塞性肺疾病和支气管扩张症。他们报告工作生产力损失更大，日常活动受损，中重度恶化更多。哮喘伴 CC 的患者疾病负担显著增加，恶化、医疗保健利用以及工作生产力和日常活动受损的情况更为严重。这些观察结果表明哮喘伴 CC 的患者存在潜在的临床影响，需要更多地关注这一方面的哮喘。
