Rees P J, Clark T J
Br J Dis Chest. 1984 Jan;78(1):55-61.
The effects of voluntary coughs on specific conductance measurements were studied in normal, atopic and asthmatic subjects before and after bronchoconstriction with histamine. The responses were variable, the most frequent change being temporary bronchodilation in the 30 seconds after a voluntary cough in the presence of histamine-induced bronchoconstriction. The effects of the two components of coughing, namely a full inhalation and a cough without a preceding deep inhalation, were studied in a similar manner. After challenge with histamine had reduced specific conductance by approximately 50%, full inhalations produced a temporary increase in conductance. Modified coughs without deep inhalation after histamine most often resulted in a temporary small decrease in conductance. One atopic subject showed marked, prolonged airway narrowing after a single full inhalation before histamine. We conclude that the major effects on airway smooth muscle produced by coughs result from the deep inhalation. In challenge studies coughs may affect subsequent airways resistance measurements. Such brief changes are not clinically important but may affect the results of inhalation challenge studies. Occasionally individuals show more prolonged bronchoconstriction after such manoeuvres.
在正常、特应性和哮喘受试者中,研究了组胺诱发支气管收缩前后自主咳嗽对比电导测量的影响。反应各不相同,最常见的变化是在组胺诱发支气管收缩时,自主咳嗽后30秒内出现短暂的支气管扩张。以类似方式研究了咳嗽的两个组成部分的影响,即一次完全吸气和一次无前驱深吸气的咳嗽。在组胺激发使比电导降低约50%后,完全吸气使电导暂时增加。组胺激发后无前驱深吸气的改良咳嗽最常导致电导暂时小幅下降。一名特应性受试者在组胺激发前单次完全吸气后出现明显、持续时间较长的气道狭窄。我们得出结论,咳嗽对气道平滑肌的主要影响来自深吸气。在激发研究中,咳嗽可能会影响随后的气道阻力测量。这种短暂变化在临床上并不重要,但可能会影响吸入激发研究的结果。偶尔,个体在这些操作后会出现更长时间的支气管收缩。