【摘要】 目的探讨下气道炎症在上气道咳嗽综合征(UACS)发生机制中的作用。方法选择UACS患者10例,并与无咳嗽的10例慢性鼻炎或鼻窦炎患者和10例健康志愿者比较。分析各组吸入辣椒素诱发≥2次或≥5次咳嗽的C2和C5咳嗽阈值,诱导痰中细胞数量和成分,以及上清液中组胺和前列腺素E2(PGE2)含量的变化。结果UACS患者咳嗽阈值明显低于无咳嗽的慢性鼻炎或鼻窦炎患者[C2:(0.65±0.08)μmol/L比(3.90±1.37)μmol/L;C5:(1.59±0.28)μmol/L比(33.46±23.71)μmol/L,P均<0.05],但后者与健康志愿者比较无显著差异(P均>0.05)。UACS患者诱导痰中炎性细胞总数较健康志愿者升高,单核细胞比例明显降低,中性粒细胞比例增高(P<0.05),但与无咳嗽的慢性鼻炎或鼻窦炎患者比较无明显差异(P>0.05)。UACS患者诱导痰上清液中组胺和PGE2均高于无咳嗽的慢性鼻炎或鼻窦炎患者[组胺:(9.55±1.89)ng/mL比(2.37±0.25)ng/mL;PGE2:(361.71±39.38)pg/mL比(144.34±15.69)pg/mL;P均<0.05],而后者与健康志愿者无明显差异(P均>0.05)。结论气道炎症引起的咳嗽高敏感性可能在UACS的发生中起重要作用,下气道黏膜肥大细胞激活可能是重要因素。更多还原

【Abstract】 Objective To explore the effect of lower airway inflammation on the pathogenesis of upper airway cough syndrome(UACS).Methods Ten cases of UACS and 10 cases of chronic rhinitis or sinusitis without cough were enrolled as group A and group B,respectively.And 10 healthy volunteers were included as controls(group C).The cough threshold C2 and C5 to inhaled capsaicin,defined as the lowest concentration of capsaicin required to induce ≥2 and ≥5 coughs,was measured.The total and differential cell counts was determined in induced sputum,and the levels of histamine and prostaglandin E2 were analyzed in supernatant of sputum.Results Cough threshold was significantly lower in group A than group B[C2:(0.65±0.08) μmol/L vs(3.90±1.37) μmol/L;C5:(1.59±0.28) μmol/L vs(33.46±23.71) μmol/L,P<0.05] and comparable between group B and group C(P>0.05).Group A,similar to group B(P>0.05),contained more inflammatory cells,with decreased percentage of macrophages and increased percentage of neutrophils in induced sputum than group C(P<0.05).Furthermore,the levels of histamine[(9.55±1.89)ng/mL vs(2.37±0.25)ng/mL,P<0.05] and prostaglandin E2[(361.71±39.38)pg/mL vs(144.34±15.69) pg/mL,P<0.05] were higher in supernatant of induced sputum from group A than group B,while the latter was not different from group C(P>0.05).Conclusion Increased cough sensitivity caused by airway inflammation may be important for the pathogenesis of UACS,and the activation of mast cells in mucosa of lower airway might be an important factor.更多还原