乙醇刺激慢性咳嗽患者和正常人食道对咳嗽敏感性和气道功能的影响

Effects of esophageal alcohol perfusion on cough reflex sensitivity and lung function

目的观察乙醇刺激慢性咳嗽患者和正常人食道前后咳嗽敏感性、肺功能的变化以探讨饮酒和咳嗽的关系。方法入选慢性咳嗽患者共18例，其中胃食管反流性咳嗽 （gastroesophageal refluxinduced cough, GERC）9例，非GERC9例，同时入选8例正常人作为对照。给予所有受试者检测肺通气功能和气道阻力，间隔24h后，先记录10min内的咳嗽次数，随后经鼻饲管持续泵入乙醇含量为42％的食用白酒10m1，持续10min，记录刺激过程中和刺激结束后10min内的咳嗽次数。刺激结束10min后所有受试者需再次检测肺通气功能和气道阻力。结果GERC、非GERC患者和正常人在年龄、性别上差异无统计学意义（P值均〉0．05）。GERC、非GERC患者和正常人在乙醇刺激食道前咳嗽次数分别为0（0～9）、4（0～23）、0（0～0），刺激食道后咳嗽次数分别为0（0～42）、6（0～21）、0（0～0），刺激前后咳嗽次数比较差异无统计学意义（t=-1．208，P〉0．05；t=-0．967，P〉0．05）。同样，对比乙醇刺激食道前后GERC、非GERC患者和正常人的肺通气功能及气道阻力各指标，差异无统计学意义（P值均〉0．05）。结论少量饮酒不会影响健康个体和慢性咳嗽患者的咳嗽敏感性、肺通气功能和气道阻力。

Objective It is considered traditionally that drinking may cause or increase cough. The effect of esophageal alcohol instillation on cough reflex sensitivity and lung function was assessed in patients with chronic cough and healthy subjects. Methods A total of 18 patients with chronic cough were enrolled in present study, including 9 patients with gastroesophageal reflux induced cough （GERC）, 9 patients without GERC, called NGERC, 8 healthy subjects were enrolled as control. Esophageal instillation was performed in all subjects with 10 ml wine（40% alcohol concentration） through a nasal feeding tube for 10 minutes. Airway resistance, lung ventilation function were measured 24 hours before alcohol instillation and 10 minutes after alcohol instillation. The cough frequency was recorded for 10 minutes before and after perfusion. Results The age and gender of patients with GERC, NGERC and healthy subjects had no significant difference. The cough frequency in GERC, NGERC and healthy subjects was 0（0-9）, 4 （ 0-23 ）, 0 （0-0） 10 minutes before alcohol instillation and 0 （ 0-42 ）, 6 （ 0-21 ）, 0 （ 0-0 ） after instillation, which showed no obvious difference in before and after instillation （ t =- 1. 208, P 〉0.05; t =-0. 967, P 〈 0.05）. Similarly, no significant changes were observed either in pulmonary ventilation function or airway resistance before and after alcohol instillation. Conclusions Low consumption of wine may have no effect on the cough sensitivity, lung ventilation function and airway resistance in patients withchronic cough and healthy subjects.