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简化咳嗽积分临床应用价值的研究

Validation of the reliability and clinical value of the simplified cough score

摘要目的 验证简化咳嗽积分方法的重复性和治疗反应性.方法 选择2010年6月至2011年2月在我科就诊的119例慢性咳嗽患者,进行简化咳嗽积分、咳嗽症状积分、莱赛斯特咳嗽问卷和辣椒素咳嗽敏感性测定,分析彼此相关性,计算有效治疗后咳嗽积分的变化率、效应大小及标准化反应均数.其中99例未经治疗的咳嗽症状稳定者间隔3天接受简化咳嗽积分重复性检验.结果 间隔3天简化咳嗽积分重复性检验组内相关系数日间为0.90(95%CI=0.84 ~0.92,P=0.00),夜间为0.89(95%CI=0.91 ~0.96,P=0.00).简化咳嗽积分与咳嗽症状积分呈高度直线正相关(r日间=0.82,P =0.00;r夜间=0.92,P =0.00),与莱赛斯特咳嗽问卷总分有一定程度负相关,与辣椒素咳嗽阈值C2或C5也存在低度负相关.患者有效治疗2周后咳嗽积分变化率、效应大小及标准化反应均数日间分别为46.71%、1.16和1.05,夜间分别为71.87%、1.09和1.10.结论 简化咳嗽积分有很高的重复性和治疗反应性,可作为临床上评估咳嗽严重程度的有效工具.

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abstractsObjective To validate the repeatability of the simplified cough score and its responsiveness to effective treatment and investigate the relationship between the simplified cough score and cough symptom score.Methods A total of 119 patients with chronic cough referred to our respiratory clinic were recruited into the study between June 2010 and February 2011. Cough severity was evaluated by the simplified cough score,cough symptom score,Leicester cough questionnaire,and cough reflex sensitivity detection,and the correlations among them were analyzed.The change ratio,effect size,and standardized response mean of the simplified cough score were calculated after a 2-week course of effective treatment.The repeatability of the simplified cough score was assessed in 99 untreated patients with stable chronic cough.Results The intraclass correlation coefficient in a 3-day test-retest interval of simplified cough score was 0.90 ( 95 % CI =0.84 - 0.92,P =0.00 ) for daytime and 0.89 ( 95 % CI =0.91 - 0.96,P =0.00 ) for nighttime. There was an obvious positive linear correlation between the simplified cough score and cough symptom score ( daytime:r =0.82,P =0.00 ; nighttime:r =0.92,P =0.00 ),a significant negative linear correlation between the cough score and Leicester cough questionnaire,and a weak but significant negative correlation between the simplified cough score and cough threshold C2 or C5 to capsaicin. After a 2-week course of effective treatment,the change ratio,effect size,and standardized response mean were 46.71%,1.16,and 1.05 for daytime and 71.87%,1.09,and 1.10 for nighttime,respectively.Conclusion The simplified cough score is a reliable and valid tool for evaluation of cough severity in clinical practice.

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