Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China.
Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China.
Front Public Health. 2022 Jul 20;10:912100. doi: 10.3389/fpubh.2022.912100. eCollection 2022.
This study aimed to identify the potential risk factors for small airway dysfunction (SAD) in non-smokers with chronic cough.
Non-smokers with chronic cough who underwent lung function tests at Xiangya Hospital from May 2019 to May 2020 were enrolled, and divided into the derivation and validation cohorts based on their hospital admission time. SAD was determined based on the presence of at least two of the following three indicators of lung function being less than 65% of predicted: maximal mid-expiratory flow, forced expiratory flow at 50% of forced vital capacity (FVC), and forced expiratory flow at 75% of FVC. Clinical data of these patients were collected. Risk factors for SAD were identified by logistic regression analysis in the derivation cohort and further confirmed in the validation cohort.
In total, 316 patients (152 in the non-SAD group and 164 in the SAD group) were included in the derivation cohort. Compared with the non-SAD group, the SAD group had a higher proportion of female patients (82.3 vs. 59.2%, < 0.001), was more commonly exposed to second-hand smoke (SHS) (61.6 vs. 27.6%, < 0.001), and tended to be older (median age, 45.5 vs. 40.0 years old, = 0.004). The median FVC, forced expiratory volume in one second (FEV) % pred, FEV/FVC ratio, and peak expiratory flow (PEF) % pred were slightly lower in the SAD group. Multivariable logistic analysis showed that exposure to SHS was an independent risk factor (OR 4.166 [95% CI 2.090-8.302], < 0.001) for SAD in non-smokers with chronic cough after adjusting for related variables. In the validation cohort ( = 146), patients with SHS exposure had a relative risk of 1.976 (95% CI 1.246-3.135, = 0.004) for SAD compared to those without SHS exposure. Multivariable logistic analysis consistently confirmed that exposure to SHS was an independent risk factor (OR 3.041 [95% CI 1.458-6.344], = 0.003) for SAD in non-smokers.
Exposure to SHS is independently associated with a higher risk of SAD in non-smokers with chronic cough. Reduction in SHS exposure may ameliorate lung function, thus lowering the risk of irreversible airway obstruction.
本研究旨在确定慢性咳嗽非吸烟者小气道功能障碍（SAD）的潜在危险因素。
本研究纳入了 2019 年 5 月至 2020 年 5 月在湘雅医院接受肺功能检查的慢性咳嗽非吸烟者，并根据入院时间将其分为推导队列和验证队列。SAD 定义为至少存在以下三项肺功能指标中的两项低于预计值的 65%：最大呼气中期流量、用力肺活量（FVC）的 50%时的呼气流量（FEF50%）和 FVC 的 75%时的呼气流量（FEF75%）。收集这些患者的临床数据。在推导队列中通过逻辑回归分析确定 SAD 的危险因素，并在验证队列中进一步确认。
共纳入 316 例患者（非 SAD 组 152 例，SAD 组 164 例）进入推导队列。与非 SAD 组相比，SAD 组女性患者比例更高（82.3%比 59.2%，<0.001），更常接触二手烟（SHS）（61.6%比 27.6%，<0.001），且年龄更大（中位数年龄，45.5 岁比 40.0 岁，=0.004）。SAD 组的 FVC、用力肺活量（FEV）%预计值、FEV/FVC 比值和呼气峰流量（PEF）%预计值略低。多变量逻辑分析显示，调整相关变量后，接触 SHS 是慢性咳嗽非吸烟者 SAD 的独立危险因素（比值比 4.166[95%置信区间 2.090-8.302]，<0.001）。在验证队列（n=146）中，与无 SHS 暴露相比，有 SHS 暴露的患者发生 SAD 的相对风险为 1.976（95%置信区间 1.246-3.135，=0.004）。多变量逻辑分析一致证实，接触 SHS 是慢性咳嗽非吸烟者 SAD 的独立危险因素（比值比 3.041[95%置信区间 1.458-6.344]，=0.003）。
接触 SHS 与慢性咳嗽非吸烟者发生 SAD 的风险增加独立相关。减少 SHS 暴露可能会改善肺功能，从而降低不可逆气道阻塞的风险。
