慢性咳嗽患者的生活环境暴露情况及其与激素敏感性咳嗽的关联分析  

Association between environmental exposure and hormone-sensitive cough in patients with chronic cough

作　　者：蔡光云 蔡燕君 王李滨 周智颖 张弋[2] 许浦生[2] Cai Guangyun;Cai Yanjun;Wang Libin;Zhou Zhiying;Zhang Yi;Xu Pusheng(Department of General Practice,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510280,China;Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China)

机构地区：[1]广州医科大学附属第二医院全科医学科,广州510280 [2]广州医科大学附属第二医院呼吸与危重症科,广州510260

出　　处：《中华全科医师杂志》2024年第4期368-374,共7页Chinese Journal of General Practitioners

基　　金：广东省医学科研基金指令性课题(C2019006)。

摘　　要：目的探讨慢性咳嗽患者的日常生活环境暴露情况及其与激素敏感性咳嗽的关联。方法回顾性分析广州医科大学附属第二医院2016年6月至2021年6月门诊收治的所有单一病因且生活环境暴露情况资料完整的慢性咳嗽患者的生活环境暴露情况,包括居住环境、室内环境、吸烟情况、尘螨霉菌暴露等共计28项。分为激素敏感性咳嗽(CRC)组与非激素敏感性咳嗽(NCRC)组,采用二元logistic回归分析模型,分析生活环境暴露情况与慢性咳嗽患者激素敏感性的关联。结果资料完整、病因诊断明确且病因单一的慢性咳嗽患者共197例,男性82例(41.63%),女性115例(58.37%)。197例慢性咳嗽患者中,75.1%(148/197)有吸烟史,16.8%(33/197)有过敏史。66.0%(130/197)居住在城市中心,18.3%(36/197)居住地周围有化工厂,11.2%(22/197)发病前半年内房屋有装修,15.7%(31/197)购买新家具,54.3%(107/197)家中种植花草,21.3%(42/197)家中饲养宠物,79.2%(156/197)房屋居住时间超过2年,71.1%(140/197)家中有蟑螂,16.2%(32/197)家中有霉斑,83.3%(164/197)空调清洗频率>2个月/次。CRC患者130例(66.0%),NCRC患者67例(34.0%)。二元logistic回归分析显示,居住地接近主干道(OR=2.296,95%CI:1.350~3.904,P=0.002),居住环境周围有化工厂存在(OR=3.322,95%CI:2.158~5.573,P<0.001),有食物或物品过敏史(OR=2.175,95%CI:1.165~4.058,P=0.015),发病前半年家中购买新家具(OR=2.828,95%CI:1.402~5.706,P=0.004),家中更多使用棉麻材料窗帘(OR=1.875,95%CI:1.038~3.388,P=0.037)与CRC呈正向关联;长期使用鹅绒、羊毛等动物材料的枕芯、被芯(OR=0.142,95%CI:0.033~0.602,P=0.008;OR=0.207,95%CI:0.067~0.640,P=0.006),开窗通风频率低(OR=0.281,95%CI:0.131~0.603,P=0.001)与CRC呈负向关联。结论CRC与非CRC患者的日常生活环境暴露情况存在差异,有食物或物品过敏史、居住地临近主干道、周围有化工厂、使用棉麻材料窗帘、发病前半年购买新家具与CRC呈正向关联�Objective To explore the association between environment exposure and hormone-sensitive cough in patients with chronic cough.Methods Clinical data of 197 patients with chronic cough visited outpatient clinic of the Second Affiliated Hospital of Guangzhou Medical University from June 2016 to June 2021 were retrospectively analyzed,including 130 cases of corticosteroid responsive cough(CRC,66.0%)and 67 cases of non-corticosteroid responsive cough(NCRC,34.0%).The association between living environment exposure and hormone sensitivity was examined with a binary logistic regression analysis.Results Among 197 patients with chronic cough,there were 82 males(41.6%)and 115 females(58.4%).75.1%(148/197)had a history of smoking,and 16.8%(33/197)had a history of allergies.66.0%(130/197)lived in the city center,18.3%(36/197)had a chemical factory around their place of residence,11.2%(22/197)renovated their homes within the first six months of the disease,15.7%(31/197)purchase new furniture,54.3%(107/197)plant flowers and plants in their houses,21.3%(42/197)keep pets in their houses,79.2%(156/197)had lived in their houses for more than 2 years,71.1%(140/197)had cockroaches in their houses,16.2%(32/197)had mold in their houses,83.3%(164/197)had a frequency of air conditioning cleaning exceeds 2 months per time.There were 130 patients(66.0%)with CRC and 67 patients(34.0%)with NCRC.Binary logistic regression analysis showed that living close to the main road(OR=2.296,95%CI:1.350-3.904,P=0.002),living near chemical factories(OR=3.322,95%CI:2.158-5.573,P<0.001),history of allergy(OR=2.175,95%CI:1.165-4.058,P=0.015),purchasing new furniture within 6 months(OR=2.828,95%CI:1.402-5.706,P=0.004),cotton and linen curtains(OR=1.875,95%CI:1.038-3.388,P=0.037)were positively correlated with CRC;while down and wool pillowcases and quilts(OR=0.142,95%CI:0.033-0.602,P=0.008;OR=0.207,95%CI:0.067-0.640,P=0.006)and low ventilation frequency(OR=0.281,95%CI:0.131-0.603,P=0.001)were negatively correlated with CRC.Conclusion Hormone-sensitive cough p

关 键 词：咳嗽 环境暴露 激素敏感 关联分析 

分 类 号：R441.5[医药卫生—诊断学]