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特发性肺纤维化相关咳嗽的特征。一项病例对照研究。

Characteristics of idiopathic pulmonary fibrosis -associated cough. a case-control study.

机构信息

Division of Respiratory Medicine, Institute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, 1627, 70211, Kuopio, PO, Finland.

Center of Medicine and Clinical Research, Division of Respiratory Medicine, Kuopio University Hospital, PO 100, 70029, Kuopio, Finland.

出版信息

BMC Pulm Med. 2023 May 23;23(1):179. doi: 10.1186/s12890-023-02476-7.

Abstract

BACKGROUND

Most patients with idiopathic pulmonary fibrosis (IPF) complain of cough. IPF-associated cough is widely characterized as dry or non-productive. The aim of this study was to compare chronic cough in early stage IPF patients to cough in subjects with chronic cough from a community-based sample and, especially, to investigate whether cough in IPF is less productive than chronic cough in a community-based sample.

METHODS

The IPF cough population consisted of 46 biopsy-confirmed patients who complained of chronic cough. Control population consisted of subjects with chronic cough, gathered by a community-based email survey sent to public service employees and the Finnish Pensioners' Federation. A case-control setting was applied by having four age, gender, and smoking-status matched subjects from the community sample for each IPF cough patient. A cough specific quality of life questionnaire (Leicester Cough Questionnaire (LCQ)) was filled in by all subjects. The LCQ questionnaire contains 19 questions, each question is scored from 1 to 7 and total score from 3 to 21 with a smaller value indicating more severe impairment.

RESULTS

The sputum production frequency, as assessed by LCQ question 2, was 5.0 (3.0-6.0) in the IPF chronic cough population and 5.0 (3.0-6.0) in the community-based chronic cough population (median and interquartile range p= 0.72). The LCQ total score was 14.8 (11.5-18.1) in the IPF chronic cough population and 15.4 (13.0-17.5) in the community-based chronic cough population (p=0.76). The domain impact scores were physical, 4.9 (3.9-6.1) vs. 5.1 (4.5-5.6) (p=0.80); psychological, 4.6 (3.7-5.9) vs. 4.7 (3.9-5.7) (p=0.90); and social, 5.5 (3.7-6.5) vs. 5.5 (4.5-6.3) (p=0.84), respectively. Furthermore, cough response to paint or fumes, cough disturbing sleep, and cough frequency per day did not differ between the groups.

CONCLUSION

Cough in early stage IPF patients was not distinguishable from chronic cough in the community-based population by LCQ. Especially, there was no difference in the self-reported frequency of cough-associated sputum production.

摘要

背景

大多数特发性肺纤维化(IPF)患者都有咳嗽症状。与 IPF 相关的咳嗽通常表现为干咳或无痰。本研究旨在比较早期 IPF 患者的慢性咳嗽与社区慢性咳嗽患者的咳嗽,并特别研究 IPF 患者的咳嗽是否比社区慢性咳嗽患者的咳嗽咳痰程度更轻。

方法

IPF 咳嗽人群由 46 名经活检证实的慢性咳嗽患者组成。对照组由通过向公共服务人员和芬兰养老金联合会发送基于社区的电子邮件调查收集的慢性咳嗽患者组成。采用病例对照设计,即从社区样本中为每个 IPF 咳嗽患者匹配 4 名年龄、性别和吸烟状况匹配的对照。所有患者均填写了咳嗽特异性生活质量问卷(莱斯特咳嗽问卷(LCQ))。LCQ 问卷共有 19 个问题,每个问题的分值为 1 至 7 分,总分 3 至 21 分,分值越低表示咳嗽对生活质量的影响越严重。

结果

LCQ 问题 2 评估的痰液产生频率,在 IPF 慢性咳嗽人群中为 5.0(3.0-6.0),在社区慢性咳嗽人群中为 5.0(3.0-6.0)(中位数和四分位距,p=0.72)。在 IPF 慢性咳嗽人群中,LCQ 总分为 14.8(11.5-18.1),在社区慢性咳嗽人群中为 15.4(13.0-17.5)(p=0.76)。在物理、心理和社会领域的影响评分分别为:物理领域 4.9(3.9-6.1)比 5.1(4.5-5.6)(p=0.80);心理领域 4.6(3.7-5.9)比 4.7(3.9-5.7)(p=0.90);社会领域 5.5(3.7-6.5)比 5.5(4.5-6.3)(p=0.84)。此外,两组患者对油漆或烟雾的咳嗽反应、咳嗽对睡眠的影响以及每天咳嗽的频率均无差异。

结论

根据 LCQ,早期 IPF 患者的咳嗽与社区人群的慢性咳嗽无法区分。特别是,咳嗽相关咳痰的自我报告频率没有差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae5d/10207773/136509537e8a/12890_2023_2476_Fig1_HTML.jpg

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