痰中性粒細胞比例與咳嗽變異性哮喘治療反應性的相關性_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 劉博 , 張婷婷 , 鄒雪 , 滿益娟 , 張寶昕

河北省滄州中西醫結合醫院（河北滄州 061001）;

Corresponding?author：

劉博, Email: liu_b709017@163.com

Keywords：

咳嗽變異性哮喘; 中性粒細胞比例; 治療反應性; 相關性

DOI：

10.7507/1671-6205.202509109

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的探討痰中性粒細胞比例與咳嗽變異性哮喘（cough-variant asthma，CVA）治療反應性的相關性。方法選取2023年10月—2024年10月我院收治的CVA患者129例為研究對象，基于治療前痰中性粒細胞比例劃分為三組：A組43例（痰中性粒細胞比例≥65%），B組43例（痰中性粒細胞比例40%～64%），C組43例（痰中性粒細胞比例≤39%）。比較三組治療前后肺功能指標［呼氣峰流速（peak expiratory flow，PEF）、第1秒用力呼氣容積（forced expiratory volume in the first second，FEV₁）、FEV₁/用力肺活量（forced vital capacity，FVC）］，咳嗽癥狀評分［視覺模擬評分（visual analogue scale，VAS）、簡易咳嗽程度評分表（cough evaluation test，CET）、中文版萊斯特咳嗽問卷（Leicester cough questionnaire，LCQ）］。以VAS下降≥30 mm和/或LCQ改善≥50%為治療反應性標準，將患者分為反應組和無反應組，采用多因素logistic回歸分析影響因素，并通過限制性立方樣條擬合痰中性粒細胞比例與治療反應性的非線性關系。結果治療后，三組患者的FVC、PEF、FEV₁/FVC、FEV₁%pred均有所提高，且C組提升幅度顯著高于A組和B組，B組高于A組（P<0.05）。治療后，三組患者的VAS評分、CET分均有所下降，其中C組下降幅度最大，其次為B組，A組下降幅度最小（P<0.05）；LCQ評分有所提高，其中C組最大，其次為B組，A組最小（P<0.05）。129例患者中，41例治療無反應（無反應組），其余88例有反應（反應組）。反應組年齡較無反應組小，FVC、PEF、FEV₁/FVC水平較無反應組高，痰中性粒細胞比例較無反應組低（P<0.05）。多因素logistic回歸分析顯示，年齡、痰中性粒細胞比例為治療反應性的危險因素，FVC、FEV₁/FVC為治療反應性的保護因素（P<0.05）。限制性立方樣條模型顯示，痰中性粒細胞比例與CVA治療反應性呈非線性劑量-反應關系。結論痰中性粒細胞比例與CVA治療反應性有關。

Citation： 劉博, 張婷婷, 鄒雪, 滿益娟, 張寶昕. 痰中性粒細胞比例與咳嗽變異性哮喘治療反應性的相關性. Chinese Journal of Respiratory and Critical Care Medicine, 2026, 25(5): 351-355. doi: 10.7507/1671-6205.202509109 Copy

1.	Cox JK, Lockey R, Cardet JC. Cough-variant asthma: a review of clinical characteristics, diagnosis, and pathophysiology. J Allergy Clin Immunol Pract, 2025, 13(3): 490-498.
2.	Zhu Z, Wu J, Chen W, et al. Bibliometric analysis of cough variant asthma from 1993 to 2022. J Asthma Allergy, 2024, 17: 517-537.
3.	Lai K, Zhan W, Wu F, et al. Clinical and inflammatory characteristics of the Chinese APAC cough variant asthma cohort. Front Med (Lausanne), 2021, 8: 807385.
4.	Diab N, Patel M, O'Byrne P, et al. Narrative review of the mechanisms and treatment of cough in asthma, cough variant asthma, and non-asthmatic eosinophilic bronchitis. Lung, 2022, 200(6): 707-716.
5.	Chen Z, Jin K, Huang K, et al. Sputum metabolomic signature and dynamic change of cough variant asthma. Am J Respir Cell Mol Biol, 2025, 72(3): 285-296.
6.	Nabe T. Steroid-resistant asthma and neutrophils. Biol Pharm Bull, 2020, 43(1): 31-35.
7.	De Volder J, Vereecke L, Joos G, et al. Targeting neutrophils in asthma: A therapeutic opportunity? Biochem Pharmacol, 2020, 182: 114292.
8.	中華醫學會呼吸病學分會哮喘學組. 咳嗽的診斷與治療指南(2021). 中華結核和呼吸雜志, 2022, 45(1): 13-46.
9.	Schmit KM, Coeytaux RR, Goode AP, et al. Evaluating cough assessment tools: a systematic review. Chest, 2013, 144(6): 1819-1826.
10.	Zhan W, Zhang L, Jiang M, et al. A new simple score of chronic cough: cough evaluation test. BMC Pulm Med, 2020, 20(1): 68.
11.	嚴廣斌. 視覺模擬評分法. 中華關節外科雜志(電子版), 2014, 8(2): 273.
12.	Zhan W, Wu F, Zhang Y, et al. Identification of cough-variant asthma phenotypes based on clinical and pathophysiologic data. J Allergy Clin Immunol, 2023, 152(3): 622-632.
13.	Jin L, Gong H, Zhang Q. The clinical differences between cough variant asthma cells and humoral immunology indicators. Cell Mol Biol (Noisy-le-grand), 2022, 68(4): 188-193.
14.	Busse W W. What Are Those Neutrophils Doing in Severe Asthma Anyway? J Allergy Clin Immunol Pract, 2019, 7(2): 526-528.
15.	Mastalerz L, Celejewska-Wojcik N, Cmiel A, et al. Non-eosinophilic asthma in nonsteroidal anti-inflammatory drug exacerbated respiratory disease. Clin Transl Allergy, 2023, 13(3): e12235.
16.	Smith BM, Zhao N, Olivenstein R, et al. Asthma and fixed airflow obstruction: long-term trajectories suggest distinct endotypes. Clin Exp Allergy, 2021, 51(1): 39-48.
17.	Bihlet A R, Karsdal M A, Sand J M, et al. Biomarkers of extracellular matrix turnover are associated with emphysema and osinophilic-bronchitis in COPD. Respir Res, 2017, 18(1): 22.
18.	Henley K, Tresselt E, Hook J S, et al. Granular insights: neutrophil predominance and elastase release in severe asthma exacerbations in a pediatric cohort. Cells, 2024, 13(6): 533.
19.	Britt RJ, Ruwanpathirana A, Ford ML, et al. Macrophages orchestrate airway inflammation, remodeling, and resolution in asthma. Int J Mol Sci, 2023, 24(13): 10451.
20.	An Z, Li J, Yu J, et al. Neutrophil extracellular traps induced by IL-8 aggravate atherosclerosis via activation NF-kappa B signaling in macrophages. Cell Cycle, 2019, 18(21): 2928-2938.
21.	Yang Z, Li X, Wei L, et al. Involucrasin B suppresses airway inflammation in obese asthma by inhibiting the TLR4-NF-kappaB-NLRP3 pathway. Phytomedicine, 2024, 132: 155850.

1. Cox JK, Lockey R, Cardet JC. Cough-variant asthma: a review of clinical characteristics, diagnosis, and pathophysiology. J Allergy Clin Immunol Pract, 2025, 13(3): 490-498.
2. Zhu Z, Wu J, Chen W, et al. Bibliometric analysis of cough variant asthma from 1993 to 2022. J Asthma Allergy, 2024, 17: 517-537.
3. Lai K, Zhan W, Wu F, et al. Clinical and inflammatory characteristics of the Chinese APAC cough variant asthma cohort. Front Med (Lausanne), 2021, 8: 807385.
4. Diab N, Patel M, O'Byrne P, et al. Narrative review of the mechanisms and treatment of cough in asthma, cough variant asthma, and non-asthmatic eosinophilic bronchitis. Lung, 2022, 200(6): 707-716.
5. Chen Z, Jin K, Huang K, et al. Sputum metabolomic signature and dynamic change of cough variant asthma. Am J Respir Cell Mol Biol, 2025, 72(3): 285-296.
6. Nabe T. Steroid-resistant asthma and neutrophils. Biol Pharm Bull, 2020, 43(1): 31-35.
7. De Volder J, Vereecke L, Joos G, et al. Targeting neutrophils in asthma: A therapeutic opportunity? Biochem Pharmacol, 2020, 182: 114292.
8. 中華醫學會呼吸病學分會哮喘學組. 咳嗽的診斷與治療指南(2021). 中華結核和呼吸雜志, 2022, 45(1): 13-46.
9. Schmit KM, Coeytaux RR, Goode AP, et al. Evaluating cough assessment tools: a systematic review. Chest, 2013, 144(6): 1819-1826.
10. Zhan W, Zhang L, Jiang M, et al. A new simple score of chronic cough: cough evaluation test. BMC Pulm Med, 2020, 20(1): 68.
11. 嚴廣斌. 視覺模擬評分法. 中華關節外科雜志(電子版), 2014, 8(2): 273.
12. Zhan W, Wu F, Zhang Y, et al. Identification of cough-variant asthma phenotypes based on clinical and pathophysiologic data. J Allergy Clin Immunol, 2023, 152(3): 622-632.
13. Jin L, Gong H, Zhang Q. The clinical differences between cough variant asthma cells and humoral immunology indicators. Cell Mol Biol (Noisy-le-grand), 2022, 68(4): 188-193.
14. Busse W W. What Are Those Neutrophils Doing in Severe Asthma Anyway? J Allergy Clin Immunol Pract, 2019, 7(2): 526-528.
15. Mastalerz L, Celejewska-Wojcik N, Cmiel A, et al. Non-eosinophilic asthma in nonsteroidal anti-inflammatory drug exacerbated respiratory disease. Clin Transl Allergy, 2023, 13(3): e12235.
16. Smith BM, Zhao N, Olivenstein R, et al. Asthma and fixed airflow obstruction: long-term trajectories suggest distinct endotypes. Clin Exp Allergy, 2021, 51(1): 39-48.
17. Bihlet A R, Karsdal M A, Sand J M, et al. Biomarkers of extracellular matrix turnover are associated with emphysema and osinophilic-bronchitis in COPD. Respir Res, 2017, 18(1): 22.
18. Henley K, Tresselt E, Hook J S, et al. Granular insights: neutrophil predominance and elastase release in severe asthma exacerbations in a pediatric cohort. Cells, 2024, 13(6): 533.
19. Britt RJ, Ruwanpathirana A, Ford ML, et al. Macrophages orchestrate airway inflammation, remodeling, and resolution in asthma. Int J Mol Sci, 2023, 24(13): 10451.
20. An Z, Li J, Yu J, et al. Neutrophil extracellular traps induced by IL-8 aggravate atherosclerosis via activation NF-kappa B signaling in macrophages. Cell Cycle, 2019, 18(21): 2928-2938.
21. Yang Z, Li X, Wei L, et al. Involucrasin B suppresses airway inflammation in obese asthma by inhibiting the TLR4-NF-kappaB-NLRP3 pathway. Phytomedicine, 2024, 132: 155850.

Previous Article
MST1 participates in the pathogenesis of sepsis-induced acute lung injury through regulation of Nrf2/HO-1 pathway
Next Article
妊娠哮喘可治療特質及生物制劑應用

Chinese Journal of Respiratory and Critical Care Medicine

痰中性粒細胞比例與咳嗽變異性哮喘治療反應性的相關性

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content