Wang Zhi-hong, Lin Jiang-tao, Li Yong, Gao Jie, Zhu Jia-jia
Department of Respiratory, China-Japan Friendship Hospital, Beijing 100029, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2007 Oct;29(5):665-8.
To analyze the etiological diagnosis and efficacy of specific therapy of chronic cough.
Totally 106 patients with chronic cough were diagnosed using a diagnostic protocol based on the Guideline on Diagnosis and Treatment of Chronic Cough established by China Medical Association, which included history inquiry, physical examination, pulmonary function tests, X-ray or CT of paranasal sinuses or chest, 24-hour esophageal pH monitoring, and sputum cell differentials. The etiological diagnosis was made according to clinical manifestations, examination results, and response to specific therapy.
The cause of chronic cough was confirmed in 101 patients (95.3%). Cough due to a single cause was found in 81 patients (80.2%), and due to multiple causes in 20 patients (19.8%). The causes included cough variant asthma (CVA) in 66 patients (62.3%), postnasal drip syndrome (PNDs) in 15 patients (14.1%), gastroesophageal reflux (GERC) in 11 patients (10.4%), post-infection cough (PIC) in 4 patients (3.8%), angiotensin converting enzyme inhibitor (ACEI) induction in 3 patients (2.8%), and eosinophilic bronchitis (EB) in 2 patients (1.9%). Five patients (4.7%) had not been definitely diagnosed. After specific therapy based on diagnosis, cough disappeared in 92 patients (91.1%) and alleviated in 9 patients (8.9%).
CVA, PNDs, and GERC are the most common causes of chronic cough. Specific therapy based on definite cause can result in good outcome.
分析慢性咳嗽的病因诊断及特异性治疗的疗效。
依据中华医学会制定的《慢性咳嗽诊断与治疗指南》中的诊断方案,对106例慢性咳嗽患者进行诊断,包括病史询问、体格检查、肺功能测试、鼻窦或胸部X线或CT、24小时食管pH监测及痰细胞分类。根据临床表现、检查结果及特异性治疗反应做出病因诊断。
101例患者(95.3%)明确了慢性咳嗽病因。单一病因所致咳嗽81例(80.2%),多种病因所致咳嗽20例(19.8%)。病因包括咳嗽变异性哮喘(CVA)66例(62.3%)、鼻后滴漏综合征(PNDs)15例(14.1%)、胃食管反流(GERC)11例(10.4%)、感染后咳嗽(PIC)4例(3.8%)、血管紧张素转换酶抑制剂(ACEI)诱发咳嗽3例(2.8%)、嗜酸性粒细胞性支气管炎(EB)2例(1.9%)。5例患者(4.7%)未明确诊断。根据诊断进行特异性治疗后,92例患者(91.1%)咳嗽消失,9例患者(8.9%)咳嗽减轻。
CVA、PNDs和GERC是慢性咳嗽最常见的病因。基于明确病因的特异性治疗可取得良好疗效。