Cloutier M M, Loughlin G M
Pediatrics. 1981 Jan;67(1):6-12.
Fifteen children who presented with chronic cough as an isolated manifestation of respiratory disease were evaluated for the presence of exercise-induced airway hyperreactivity. Pulmonary function tests using air and a helium/oxygen gas mixture were performed before exercise. Eight subjects were also evaluated by spirometry and maximum expiratory flow volume curves before and after isoproterenol inhalation on a separate day. Ten subjects had normal pulmonary function tests at rest and five had isolated minor abnormalities. No significant changes in pulmonary function tests were recorded after inhalation of isoproterenol in the eight subjects studied. Following exercise, all 15 subjects demonstrated changes in pulmonary function tests which were similar to those seen in children with mild exercise-induced bronchospasm. After institution of theophylline, exercise-induced decreases in flow rates low in the vital capacity were blocked in all subjects; however, several subjects had persistent mild decreases in peak flow. Within six months of discontinuing the theophylline, cough recurred in 11 of the 15 subjects. Nine subjects were restudied after return of their cough. Exercise again resulted in decreased lung function. Reinstitution of theophylline eliminated the cough in these nine subjects. This study demonstrates that chronic cough in some children may be a manifestation of airway hyperreactivity. Both the cough and the reactivity can be blocked with theophylline.
对15名以慢性咳嗽作为呼吸道疾病唯一表现的儿童进行了运动诱发气道高反应性评估。在运动前使用空气和氦氧混合气进行肺功能测试。另外8名受试者在单独一天吸入异丙肾上腺素前后还通过肺活量测定法和最大呼气流量容积曲线进行了评估。10名受试者静息时肺功能测试正常，5名受试者有孤立的轻度异常。在研究的8名受试者中，吸入异丙肾上腺素后肺功能测试无显著变化。运动后，所有15名受试者的肺功能测试均出现变化，与轻度运动诱发支气管痉挛儿童的情况相似。使用茶碱后，所有受试者肺活量较低时运动诱发的流速降低均被阻断；然而，几名受试者的峰值流速持续轻度降低。停用茶碱后6个月内，15名受试者中有11名再次出现咳嗽。9名受试者咳嗽复发后再次接受研究。运动再次导致肺功能下降。重新使用茶碱消除了这9名受试者的咳嗽。这项研究表明，一些儿童的慢性咳嗽可能是气道高反应性的一种表现。咳嗽和反应性均可被茶碱阻断。
