新型冠状病毒感染后亚急性咳嗽患者气道敏感性分析  

Airway sensitivity analysis of patients with subacute cough after COVID-19 infection

作　　者：李凡凡 常莹 侯淑杰 边继美 张旭[1] 关继涛[1] 阎锡新[1] Li Fanfan;Chang Ying;Hou Shujie;Bian Jimei;Zhang Xu;Guan Jitao;Yan Xixin(The First Department of Respiratory and Critical Care Medicine,the Second Hospital of Hebei Medical University,Hebei Provincial Key Laboratory of Respiratory Criticality,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院呼吸与危重症医学一科、河北省呼吸危重症重点实验室,石家庄050000

出　　处：《国际呼吸杂志》2023年第8期904-909,共6页International Journal of Respiration

基　　金：2021年政府资助临床医学优秀人才项目(冀财预复(2021)379号)。

摘　　要：目的:探讨新型冠状病毒感染后亚急性咳嗽患者在感染急性期主要症状及感染恢复期临床特征、气道反应性等方面的变化。方法:本研究为双向性队列研究。采用非随机抽样法,选取2022年11月30日至2023年1月30日在河北医科大学第二医院呼吸与危重症医学科门诊就诊的新型冠状病毒感染后亚急性咳嗽患者389例为研究对象,收集患者感染急性期病例资料,对资料完整患者,按照患者既往是否有呼吸道敏感症状,将患者分为敏感组103例和非敏感组286例。对比2组患者支气管激发试验等肺功能、呼出气一氧化氮、外周血嗜酸粒细胞及血清总IgE水平,并对咳嗽合并支气管激发试验阳性患者给予长效β受体激动剂和吸入性糖皮质激素治疗,随访对比2组症状缓解率、缓解时间。结果:新型冠状病毒感染1个月,2组患者在支气管激发试验等肺功能、呼出气一氧化氮、嗜酸粒细胞计数、IgE检测中差异均无统计学意义(均P>0.05);咳嗽合并支气管激发试验阳性患者在长效β受体激动剂和吸入性糖皮质激素治疗后,敏感组症状缓解率(60.00%,27/45)低于非敏感组(89.68%,139/155),缓解时间[35.00(20.00,60.00)d]高于非敏感组[10.00(7.00,13.75)d],差异均有统计学意义(均P<0.01)。结论:新型冠状病毒感染后患者气道反应性增高与既往气道高敏感性无关;大多数患者在药物干预后3个月内临床症状恢复正常,但对气道高敏感患者需要更长时间的干预。Objective To investigate the changes in the main symptoms of patients with subacute cough after Corona Virus Disease 2019(COVID-19)infection in the acute phase of infection and the changes in the clinical features and airway responsiveness in the recovery phase of infection.Methods This was a bidirectional cohort study.A total of 389 patients with subacute cough after COVID-19 infection visiting the outpatient clinic of the Department of Respiratory Critical Care Medicine of the Second Hospital of Hebei Medical University from November 30,2022 to January 30,2023 were non-randomly selected.The data of the patients in the acute phase of infection were collected,and patients with complete data were divided into sensitive group(103 cases)and non-sensitive group(286 cases)according to whether they had previous respiratory hypersensitivity symptoms.The lung function,such as bronchial excitation test,exhaled nitric oxide,peripheral blood eosinophils,and serum total IgE levels were compared between the two groups.The patients with cough combined with positive bronchial excitation test were treated with long-acting beta agonists and inhaled glucocorticoids.The symptom relief rate and relief time were compared between the two groups at the follow-up.Results One month after new coronary infection,there was no statistical difference between the two groups in lung function such as bronchial excitation test,exhaled breath nitric oxide,eosinophil count,and IgE test(P>0.05).After long-acting beta agonists and inhaled glucocorticoids treatment in patients with cough combined with positive bronchial excitation test,the symptom remission rate was lower in the sensitive group(60.00%,27/45)than that in the non-sensitive group(89.68%,139/155),and the remission time(35.00[20.00,60.00]days)was longer than that in the non-sensitive group(10.00[7.00,13.75]days),with statistical differences(both P<0.01).Conclusions Increased airway responsiveness in patients after COVID-19 infection was not associated with previous airway hypersensitivity;

关 键 词：新型冠状病毒感染 支气管激发试验 长新冠综合征 肺功能 

分 类 号：R441.5[医药卫生—诊断学] R563.1[医药卫生—临床医学]