同济大学学报（医学版）2011，Vol.32Issue(1)：68-72,5.DOI:10.3969/j.issn1008-0392.2011.01.068
咳嗽敏感性和咳嗽变异性哮喘的比较研究
Comparative study of cough variant asthma and cough reflex sensitivity
摘要
Abstract
Objectives To study the different effects of cough reflex sensitivity on the pathogenesis of cough in CVA and to explore its underlying mechanism.Methods Sixty-eight patients with CVA were divided into two subgroups according to the established normal value of cough sensitivity threshold C5:CVA with increased ( 21 cases ) or normal ( 47 cases ) cough reflex sensitivity.Twenty-six healthy volunteers were enrolled as control group.Changes in cough symptom score, lung function parameters,total cell number and differentials in induced sputum were compared among three groups.Moreover,levels of interleukin-8 ( IL-8 ) and neutrophil elastase (NE) were analyzed in supernatants of induced sputum by ELISA.Results Cough was more severe in CVA with increased cough reflex sensitivity than in CVA with normal sensitivity(4.0 ± 1.0 vs 3.1 ± 0.9, P ＜ 0.01 ).Compared with the control group, lung function parameters in both subgroups of CVA had no significant differences, while the total cells, percentages of neutrophils, IL-8 and NE were increased significantly in both subgroups of CVA.The percentage of neutrophils in induced sputum in CVA patients with increased cough reflex sensitivity was higher than that in CVA patients with normal sensitivity [(50.1 ± 25.4) ％ vs (36.6 ±19.7) ％, P ＜ 0.05].Similarly, the levels of IL-8 and NE supematants in induced sputum were higher in CVA patients with increased cough reflex sensitivity than those with the normal one [IL-8:(360.4 ±181.2) pg/ml vs (228.0±107.9) pg/ml, P＜0.01,NE: (94.1 ±16.9) ng/ml vs (67.6 ±12.9) ng/ml, P ＜ 0.01].Moreover, there was an apparent positive correlation between IL-8 and the percentage of neutrophils (P ＜ 0.01 ) or NE ( P ＜ 0.01 ), and a negative correlation between NE and Log C5 ( P ＜0.01 ).Conclusion CVA can be divided into two subgroups with increased or normal cough reflex sensitivity.The varied degrees of infiltration and the activation of neutrophils in the airway may be crucial factors associated with the difference in cough reflex sensitivity in patients with CVA.关键词
咳嗽变异性哮喘/辣椒素/咳嗽敏感性/中性粒细胞/白细胞介素-8/中性粒细胞弹性蛋白酶分类
医药卫生引用本文复制引用
黄漾,邱志宏,魏为利,余莉,吕寒静,邱忠民..咳嗽敏感性和咳嗽变异性哮喘的比较研究[J].同济大学学报（医学版）,2011,32(1):68-72,5.基金项目
上海市科委科技发展基金资助项目(074119628) （074119628）
