Division of Respiratory Medicine, Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland.
Division of Respiratory Medicine, Center of Medicine and Clinical Research, Kuopio University Hospital, POB 100, 70029, Kuopio, Finland.
Lung. 2024 Nov 28;203(1):5. doi: 10.1007/s00408-024-00755-6.
Inhaled mannitol induces bronchoconstriction and cough. This study aimed to describe the cough response to mannitol among healthy adult subjects.
125 healthy subjects (aged 18-82 years, 52% females, 50% skin prick test positive) underwent a mannitol test. The coughs were recorded both simultaneously and afterwards from video recordings by two researchers. Three indices were evaluated: The cumulative number of coughs per cumulative dose of mannitol (CDR), cumulative provocative dose of mannitol to cause at least 5 coughs, and the maximal number of coughs provoked by any single mannitol dose. The test was repeated in 26 subjects after 3-7 days.
CDR showed the best repeatability with an intraclass correlation coefficient of 0.829. Gender was the only characteristics that associated with the cough response: The median CDR was 2.53 (interquartile range 0.45-7.01) coughs/100 mg among females and 0.787 (0.0-3.29) coughs/100 mg among males (p = 0.002). The interquartile range upper limits were defined as the cut-off limits for a normal response. The threshold for a statistically significant change in CDR was 6.26 coughs/100 mg. There was a close correlation between simultaneous- and video-assessed CDR (intraclass correlation coefficient 0.985).
Females cough more than males in response to mannitol. CDR is the most suitable index to describe the cough responsiveness. The repeatability of the response is good. Video recording of the coughs is not mandatory. The cut-off limits for a normal cough response to mannitol were provided.
吸入甘露醇可诱发支气管收缩和咳嗽。本研究旨在描述健康成年受试者对甘露醇的咳嗽反应。
125 名健康受试者（年龄 18-82 岁，女性占 52%，皮肤点刺试验阳性占 50%）接受了甘露醇测试。两名研究人员同时从视频记录中记录咳嗽，并在事后进行记录。评估了三个指标：每累积剂量甘露醇的累积咳嗽次数（CDR）、引起至少 5 次咳嗽的累积甘露醇激发剂量，以及任何单次甘露醇剂量引起的最大咳嗽次数。26 名受试者在 3-7 天后重复进行了测试。
CDR 的可重复性最好，组内相关系数为 0.829。性别是唯一与咳嗽反应相关的特征：女性的 CDR 中位数为 2.53（四分位间距 0.45-7.01）/100mg，男性为 0.787（0.0-3.29）/100mg（p=0.002）。四分位间距上限定义为正常反应的截止值。CDR 的统计学显著变化阈值为 6.26 次/100mg。同时评估和视频评估的 CDR 之间存在密切相关性（组内相关系数 0.985）。
女性对甘露醇的咳嗽反应强于男性。CDR 是描述咳嗽反应性的最适宜指标。反应的可重复性良好。无需进行咳嗽的视频记录。提供了甘露醇正常咳嗽反应的截止值。
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