合并过敏性鼻炎的亚急性咳嗽患者临床分析

doi:10.3969/j.issn.1004-583X.2023.10.007

临床荟萃 ›› 2023, Vol. 38 ›› Issue (10): 904-906.doi: 10.3969/j.issn.1004-583X.2023.10.007

合并过敏性鼻炎的亚急性咳嗽患者临床分析

李远鹏^1a^,^1b, 陈亮², 刘俊安^1a, 李天林^1a^,^1b()

1a.华侨大学附属厦门长庚医院呼吸内科, 福建厦门 361000
1b.华侨大学附属厦门长庚医院过敏中心, 福建厦门 361000
2.华中科技大学深圳协和医院过敏反应科, 广东深圳 518000

收稿日期:2023-05-11 出版日期:2023-10-20 发布日期:2024-01-03
通讯作者: 李天林 E-mail:815468069@qq.com
基金资助:
厦门市科技局——浅析伴过敏性鼻炎的亚急性咳嗽患者的临床特点(3502Z20209092);厦门市科技局——浅析伴过敏性鼻炎的亚急性咳嗽患者的临床特点(CMRPG1E0181)

Clinical analysis of subacute cough in patients with allergic rhinitis

Li Yuanpeng^1a^,^1b, Chen Liang², Liu Junan^1a, Li Tianlin^1a^,^1b()

1a. Department of Respiratory Medicine, Xiamen 361000, China
1b. Department of Allergology Consortium,Xiamen Changgung Hospital Affiliated to Huaqiao University,Xiamen 361000,China
2. Department of Allergy,Huazhong University of Science and Technology Union Shenzhen Hospital,Shenzhen 518000,China

Received:2023-05-11 Online:2023-10-20 Published:2024-01-03
Contact: Li Tianlin E-mail:815468069@qq.com

摘要/Abstract

摘要： 目的探讨合并过敏性鼻炎的亚急性咳嗽患者咳嗽特点、严重程度、呼出气一氧化氮(Fractional Exhaled Nitric Oxide,FeNO)增高的情况及治疗方法。方法将526例亚急性咳嗽的患者根据有无过敏性鼻炎分为试验组和对照组,分析两组咳嗽严重程度、FeNO及出现夜间咳嗽和咽喉瘙痒症状的差别。根据FeNO检测结果高低及是否合并过敏性鼻炎病史分为A、B、C、D亚组,分别给予各亚组止咳对症、抗过敏、吸入糖皮质激素药物单独或联合治疗,分析各亚组1周后咳嗽缓解率。结果 526患者中,男性216例,平均年龄(39.68±11.95)岁,女性310例,平均年龄(38.18±12.17)岁;试验组94例(17.9%),男性46例,女性48例;对照组432例(82.1%),男性171例,女性261例。试验组的咳嗽严重程度评分中位数、四分位数间距大于对照组[4(2, 5) vs 3(2, 5), Z=3.648,P=0.000],差异有统计学意义;试验组FeNO检测结果大于25 ppb的比例高于对照组(35.5% vs 23.6%,χ²=5.647,P=0.017);试验组出现夜间咳嗽和咽喉瘙痒症状的比例高于对照组(48.4% vs 36.1%,χ²=4.887, P=0.027)。经过治疗1周后C组咳嗽缓解率均低于其他组,缓解率差异均有统计学意义;A、B和D组咳嗽缓解率较高。结论合并过敏性鼻炎的亚急性咳嗽患者咳嗽程度较严重,更多具有嗜酸性气道炎症或混合性气道炎症,联合抗过敏或吸入激素药物治疗咳嗽效果比较好。

关键词: 咳嗽, 鼻炎,过敏性, 呼出气一氧化氮检测, 夜间咳嗽, 咽喉瘙痒

Abstract: Objective To analyze the characteristics and severity of cough, as well as the increase in fractional exhaled nitric oxide (FeNO) and the treatment of subacute cough in patients with allergic rhinitis. Methods A total of 526 patients with subacute cough were divided into experimental group and control group according to the presence of allergic rhinitis or not. The severity of cough, FeNO, nocturnal cough and throat itching between the experimental group and control group were statistically analyzed. According to the FeNO test results and with the combination of allergic rhinitis, patients were further divided into subgroup A, B, C and D. They were treated with antitussive, antiallergic, inhaled corticosteroids alone or in the combination, followed by the analysis of the 1-week remission rate of cough. Results A total of 526 patients were included in the study, including 216 males with the mean age of (39.68±11.95) years and 310 females with the mean age of (38.18±12.17) years. There were 94 cases (17.9%) in the experimental group, including 46 males and 48 females, and 432 cases (82.1%) in the control group, including 171 males and 261 females. The median and quartile interval of cough severity score in the experimental group was significantly greater than those of control group (4 [2, 5] vs 3 [2, 5], Z=3.648, P=0.000). The ratio of increased FeNO (≥25 ppb) in the experimental group was significantly higher than that of control group (35.5% vs 23.6%, χ²=5.647, P=0.017). The positive rate of nocturnal cough and throat itching in the experimental group was significantly higher than that of control group (48.4% vs 36.1%, χ²=4.887, P=0.027). After one week of treatment, the cough relief rate of subgroup C was significantly lower than that of other groups, which was relatively high in subgroup A, B and D. Conclusion Allergic rhinitis patients combined with subacute cough have severer cough, eosinophilic airway inflammation or mixed airway inflammation, which is better responsive to the combination of antiallergic or inhaled corticosteroids.

Key words: cough, allergic rhinitis, fractional exhaled nitric oxide, nocturnal cough, throat itching

中图分类号:

R256.11

李远鹏, 陈亮, 刘俊安, 李天林. 合并过敏性鼻炎的亚急性咳嗽患者临床分析[J]. 临床荟萃, 2023, 38(10): 904-906.

Li Yuanpeng, Chen Liang, Liu Junan, Li Tianlin. Clinical analysis of subacute cough in patients with allergic rhinitis[J]. Clinical Focus, 2023, 38(10): 904-906.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2023.10.007

https://huicui.hebmu.edu.cn/CN/Y2023/V38/I10/904

图/表 2

表1 两组咳嗽评分、FeNO及夜间咳嗽和咽痒症状的比较

Tab. 1 Comparison of cough score, FeNO, nocturnal cough and throat itching between groups

组别	例数	咳嗽严重程度评分 [M(P25, P75)]	FeNO增高比例 [例(%)]	夜间咳嗽+咽喉瘙痒比例 [例(%)]
试验组	94	4(2, 5)	35.5	48.4
对照组	432	3(2, 5)	23.6	36.1
$Z$ /χ²值		3.648	5.647	4.887
P值		0.000	0.017	0.027

表1 两组咳嗽评分、FeNO及夜间咳嗽和咽痒症状的比较

Tab. 1 Comparison of cough score, FeNO, nocturnal cough and throat itching between groups

组别	例数	咳嗽严重程度评分 [M(P25, P75)]	FeNO增高比例 [例(%)]	夜间咳嗽+咽喉瘙痒比例 [例(%)]
试验组	94	4(2, 5)	35.5	48.4
对照组	432	3(2, 5)	23.6	36.1
$Z$ /χ²值		3.648	5.647	4.887
P值		0.000	0.017	0.027

表2 4亚组样本咳嗽缓解率比较

Tab. 2 Comparison of cough relief rates among four subgroups

组别	例数	咳嗽缓解率
试验组
A组	61	52(85.2)^*
B组	33	30(90.9)^*
对照组
C组	357	258(72.3)
D组	75	63(84.0)^*
χ²值		12.347
P值		0.006

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合并过敏性鼻炎的亚急性咳嗽患者临床分析

Clinical analysis of subacute cough in patients with allergic rhinitis

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