Department of Respiratory Medicine, Allergy, and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Japan
Department of Respiratory Medicine, Allergy, and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Japan.
BMJ Open Respir Res. 2023 Jan;10(1). doi: 10.1136/bmjresp-2022-001283.
Patients with chronic obstructive pulmonary disease (COPD) are often hospitalised due to severe acute exacerbation (AE) or community-acquired pneumonia (CAP). Previous studies revealed the association of cough reflex sensitivity with the pathophysiology of COPD and pneumonia. We hypothesised that cough reflex sensitivity may be associated with severe AE or CAP requiring hospitalisation in patients with COPD.
We prospectively recruited 68 patients with COPD between June 2018 and January 2020. Patient characteristics, lung and cardiac functions, and biomarkers, including capsaicin cough reflex sensitivity and blood eosinophil count, were evaluated at enrolment. All participants were monitored for AE or CAP requiring hospitalisation for 12 months. We determined the risk factors and ORs for hospitalisation in patients with COPD using a multivariate analysis.
Eight patients experienced AE (n=3) or CAP (n=5) and required hospitalisation during follow-up. Patients in the hospitalisation+ group had higher modified Medical Research Council scores and blood eosinophil counts (≥300 µL) than those in the hospitalisation- group. Capsaicin cough reflex sensitivity tended to decrease in the hospitalisation+ group compared with that in the hospitalisation- group. Multivariate analysis revealed that a decreased capsaicin cough reflex and high eosinophil count (≥300 µL) were predictive risk factors for future hospitalisation due to AE-COPD or CAP.
In addition to eosinophils, decreased capsaicin cough reflex sensitivity was associated with hospitalisation due to AE-COPD or CAP. Capsaicin cough reflex sensitivity in patients with COPD may play a role in the prevention of severe AE or pneumonia requiring hospitalisation.
UMIN000032497.
慢性阻塞性肺疾病（COPD）患者常因严重急性加重（AE）或社区获得性肺炎（CAP）住院。先前的研究表明咳嗽反射敏感性与 COPD 和肺炎的病理生理学有关。我们假设咳嗽反射敏感性可能与 COPD 患者因严重 AE 或 CAP 而需要住院有关。
我们前瞻性招募了 2018 年 6 月至 2020 年 1 月期间的 68 名 COPD 患者。在入组时评估患者特征、肺和心脏功能以及生物标志物，包括辣椒素咳嗽反射敏感性和血嗜酸性粒细胞计数。所有参与者均监测了 12 个月的 AE 或 CAP 住院情况。我们使用多变量分析确定 COPD 患者住院的危险因素和 OR。
8 名患者在随访期间经历了 AE（n=3）或 CAP（n=5）并需要住院治疗。与住院-组相比，住院+组的改良医学研究委员会评分和血嗜酸性粒细胞计数（≥300μL）更高。与住院-组相比，住院+组的辣椒素咳嗽反射敏感性呈下降趋势。多变量分析显示，辣椒素咳嗽反射降低和嗜酸性粒细胞计数升高（≥300μL）是 AE-COPD 或 CAP 导致未来住院的预测危险因素。
除了嗜酸性粒细胞外，辣椒素咳嗽反射敏感性降低与 AE-COPD 或 CAP 导致的住院有关。COPD 患者的辣椒素咳嗽反射敏感性可能在预防严重 AE 或需要住院的肺炎方面发挥作用。
UMIN000032497。
