Burrows B, Lebowitz M D
Am Rev Respir Dis. 1975 Sep;112(3):365-70. doi: 10.1164/arrd.1975.112.3.365.
Subjects residing in the warm, dry climate of Tucson, Arizona showed the same relationship of productive cough to smoking as noted elsewhere, but they less regularly reported seasonal or diurnal exacerbations of their symptoms and they less regularly reported phlegm production along with chronic cough. In this locale, even nonchronic dry cough was associated with an increased frequency of other respiratory symptoms and of ventilatory impairment. In comparing characteristics of subjects with a clinical diagnosis of chronic bronchitis with characteristics of subjects who had only questionnaire-detected chronic productive cough, it was found that smoking habits were more closely related to the presence of chronic cough than to the clinical diagnosis. The clinical diagnosis was associated with other features, such as wheezing, at least as often as with productive cough. This was especially true in children, in whom a suprisingly high prevalence of both chronic cough and clinically confirmed chronic bronchitis was noted. These observations led to questions concerning the appropriateness of using a common clinical term such as chronic bronchitis to describe subjects whose only known abnormality is an affirmative answer to a direct question concerning phlegm production.
居住在亚利桑那州图森温暖干燥气候地区的受试者，其 productive cough 与吸烟的关系与其他地方所指出的相同，但他们较少定期报告症状的季节性或日间加重情况，且较少定期报告伴有慢性咳嗽的咳痰情况。在这个地区，即使是非慢性干咳也与其他呼吸道症状和通气功能障碍的频率增加有关。在比较临床诊断为慢性支气管炎的受试者与仅通过问卷检测出慢性 productive cough 的受试者的特征时，发现吸烟习惯与慢性咳嗽的存在比与临床诊断的关系更为密切。临床诊断与其他特征（如喘息）相关，至少与 productive cough 一样频繁。在儿童中尤其如此，在儿童中观察到慢性咳嗽和临床确诊的慢性支气管炎的患病率惊人地高。这些观察结果引发了关于使用诸如慢性支气管炎这样的常见临床术语来描述那些唯一已知异常是对关于咳痰的直接问题给出肯定回答的受试者是否合适的疑问。
