Abstract：
OBJECTIVE: This study examines the relationship between chronic cough and vagal hypersensitivity by measuring baseline esophageal motility, with interest in the upper esophageal sphincter (UES).
METHODS: Patients undergoing workup for dysphagia were assigned to a chronic cough or control group based on self-reported symptoms. Differences in demographics, medical comorbidities, and high resolution esophageal manometry findings were obtained retrospectively.
RESULTS: 62.5% of our cohort had chronic cough (30/48). There were no significant differences between the two groups with respect to sex, age, and race/ethnicity. Laryngopharyngeal reflux (LPR) was the only statistically significant predictor of CC (OR 74.04, p = 0.010). Cough patients had upper esophageal sphincter relaxation duration (734 ms) significantly longer than the non-cough patients (582 ms; p = 0.03), though both groups had similar upper esophageal mean basal pressure, mean residual pressure, relaxation time-to-nadir, and recovery time. No significant difference was found in the median intrabolus pressure and UES motility mean peak pressure between groups.
CONCLUSIONS: Subtle differences in high-resolution manometry between patients with and without cough suggest, in line with previous studies, baseline alterations of upper esophageal function may manifest in patients with chronic cough through an undetermined mechanism that may include underlying vagal hypersensitivity. These findings encourage further manometric study examining the relationship between UES dysfunction and chronic cough.
METHODS: Patients undergoing workup for dysphagia were assigned to a chronic cough or control group based on self-reported symptoms. Differences in demographics, medical comorbidities, and high resolution esophageal manometry findings were obtained retrospectively.
RESULTS: 62.5% of our cohort had chronic cough (30/48). There were no significant differences between the two groups with respect to sex, age, and race/ethnicity. Laryngopharyngeal reflux (LPR) was the only statistically significant predictor of CC (OR 74.04, p = 0.010). Cough patients had upper esophageal sphincter relaxation duration (734 ms) significantly longer than the non-cough patients (582 ms; p = 0.03), though both groups had similar upper esophageal mean basal pressure, mean residual pressure, relaxation time-to-nadir, and recovery time. No significant difference was found in the median intrabolus pressure and UES motility mean peak pressure between groups.
CONCLUSIONS: Subtle differences in high-resolution manometry between patients with and without cough suggest, in line with previous studies, baseline alterations of upper esophageal function may manifest in patients with chronic cough through an undetermined mechanism that may include underlying vagal hypersensitivity. These findings encourage further manometric study examining the relationship between UES dysfunction and chronic cough.
摘要：
目的：本研究通过测量基线食管运动来检查慢性咳嗽与迷走神经超敏反应之间的关系，对食管上括约肌（UES）感兴趣。
方法：根据自我报告的症状，将接受吞咽困难检查的患者分为慢性咳嗽组或对照组。人口统计学差异，医疗合并症,和高分辨率食管测压结果的回顾性研究。
结果：我们队列中有62.5%患有慢性咳嗽（30/48）。两组之间在性别方面没有显着差异，年龄,和种族/民族。咽喉反流（LPR）是CC的唯一有统计学意义的预测因子（OR74.04，p=0.010）。咳嗽患者的食管上括约肌松弛持续时间（734ms）明显长于非咳嗽患者（582ms；p=0.03），尽管两组的上食管平均基础压相似，平均残余压力,弛豫时间到最低点，和恢复时间。组间的代谢内压中位数和UES运动平均峰值压力没有显着差异。
结论：有咳嗽和没有咳嗽的患者之间高分辨率测压的细微差异表明，根据以前的研究，在慢性咳嗽患者中,上食管功能的基线改变可能表现为一种机制不明,可能包括潜在的迷走神经超敏反应.这些发现鼓励进一步的测压研究，以检查UES功能障碍与慢性咳嗽之间的关系。
方法：根据自我报告的症状，将接受吞咽困难检查的患者分为慢性咳嗽组或对照组。人口统计学差异，医疗合并症,和高分辨率食管测压结果的回顾性研究。
结果：我们队列中有62.5%患有慢性咳嗽（30/48）。两组之间在性别方面没有显着差异，年龄,和种族/民族。咽喉反流（LPR）是CC的唯一有统计学意义的预测因子（OR74.04，p=0.010）。咳嗽患者的食管上括约肌松弛持续时间（734ms）明显长于非咳嗽患者（582ms；p=0.03），尽管两组的上食管平均基础压相似，平均残余压力,弛豫时间到最低点，和恢复时间。组间的代谢内压中位数和UES运动平均峰值压力没有显着差异。
结论：有咳嗽和没有咳嗽的患者之间高分辨率测压的细微差异表明，根据以前的研究，在慢性咳嗽患者中,上食管功能的基线改变可能表现为一种机制不明,可能包括潜在的迷走神经超敏反应.这些发现鼓励进一步的测压研究，以检查UES功能障碍与慢性咳嗽之间的关系。
