感冒后咳嗽敏感性及气道神经源性炎症改变

被引：63

作者：

陈如冲

刘春丽

罗炜

姚卫民

钟淑卿

赖克方

钟南山

机构：

[1] 广州医学院第一附属医院广州呼吸疾病研究所

来源：

中国实用内科杂志 | 2007年 / 09期

关键词：

咳嗽; 感冒后咳嗽; 咳嗽敏感性; 神经源性炎症; 发病机制;

D O I：

暂无

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

目的观察感冒后咳嗽患者(cough post infectious,CPI)的咳嗽敏感性以及气道分泌物神经肽变化,探讨其可能的发病机制。方法以2005年1～6月于广州呼吸疾病研究所慢性咳嗽专科门诊诊断10例CPI患者(CPI组)及10名正常志愿者(正常对照组)为研究对象,通过辣椒素咳嗽激发试验测定气道咳嗽敏感性;观察诱导痰细胞总数以及细胞分类比例;测定痰上清液P物质(SP)、神经肽A(NKA)、神经肽B(NKB)及降钙素基因相关肽(CGRP);检测诱导痰细胞SP、NKA及SP受体(NK-1)的表达,并进行分析比较。结果CPI组咳嗽阈值lgC5为1.16±0.61,明显低于正常对照组(2.64±0.28)(P<0.001)。CPI组诱导痰细胞总数(WBC)及细胞分类比例与正常对照组差异均无显著性意义。CPI组诱导痰上清液SP质量浓度为(516.3±494.2)ng/L,显著高于正常对照组[(141.7±34.5)ng/L,P<0.05];CGRP质量浓度为(141.2±80.8)ng/L,显著高于正常对照组[(74.3±38.2)ng/L,P<0.05];而2组间NKA、NKB的质量浓度差异均无显著性意义。CPI组痰细胞SP、NK-1蛋白的表达分别为1.86±0.81和1.20±0.75,显著高于正常对照组的(0.65±0.44和0.27±0.24)(P<0.01);而2组间NKA蛋白表达差异无显著性意义。结论CPI患者的咳嗽敏感性增高,并伴随气道神经源性炎症,提示其与CPI发病相关。

引用

页码：674 / 676+679 +679

页数：4

共 14 条

[1] 不明原因慢性咳嗽的病因分布及诊断程序的建立 [J].

赖克方 ;

陈如冲 ;

刘春丽 ;

罗炜 ;

钟淑卿 ;

何梦章 ;

李德容 ;

钟南山 .

中华结核和呼吸杂志, 2006, (02) :96-99

[2]

An empiric integrative approach to the management of cough:ACCP evidence-based clini-cal practice guidelines. Pratter MR,Brightling CE,Boulet LP,et al. Chest . 2006

[3]

Role of substance P in cough. Sekizawa K,Jia YX,Ebihara T,et al. Pulmonary Pharmacology and Therapeutics . 1996

[4]

Role of substance P and tachykinin receptor antagonists in citric acid-induced cough in pigs. Moreaux B,Nemmar A,Vincke G,et al. European Journal of Pharmacology . 2000

[5]

Relationship between airway responsiveness to neurokinin A and methacholine in asth-ma. Cohen J,Burggraaf J,Schoemaker RC,et al. Pulmonary Pharmacology and Therapeutics . 2005

[6]

Elevated substance P levels in nasal lavage fluids from patients with chronic nonproductive cough and increased cough sensitivity to inhaled capsaicin. Cho YS,Park SY,Lee CK,et al. The Journal of Allergy and Clinical Immunology . 2003

[7]

Expression of tachykinins in nonnociceptive vagal afferent neurons during respiratory viral in-fection in guinea pigs. Carr MJ,Hunter DD,Jacoby DB. American Journal of Respiratory and Critical Care Medicine . 2002

[8]

Abnor-mal intraepithelial airway nerves in persistent unexplained cough?. O Connell F,Springall DR,Moradoghli-Haftvani A,et al. American Journal of Respiratory and Critical Care Medicine . 1995

[9]

Eosinophilic bronchitis is an important cause of chronic cough. Brightling CE,Ward R,Goh KL,et al. American Journal of Respiratory and Critical Care Medicine . 1999

[10]

GUT[P]. YAMAMOTO HIROSHI;WATANABE HIROSHI;IMAI YUICHI;ISHIKAWA SHIRO;TSUBOKO HISASHI;KATO KENJI.日本专利:JP2000346293A,2000-12-15

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