Department of Otorhinolaryngology, Ghent University Hospital, De Pintelaan 185, Ghent, Belgium.
Respir Med. 2010 May;104(5):652-7. doi: 10.1016/j.rmed.2009.11.020. Epub 2009 Dec 14.
The epidemiological, pathophysiological and clinical links between upper and lower airways are nowadays clearly demonstrated. Most of asthmatics are suffering from rhinitis while up to 40% of rhinitic patients have asthma. Asthmatics and COPD patients are also prone to develop concomitant chronic rhinosinusitis (CRS). This study aimed to determine the predictive value of cough for concomitant asthma in patients suffering from upper airway diseases.
This cross-sectional study described a group of 143 consecutive patients suffering simultaneously from common upper and lower airway disorders. Both ENT-specialists and respiratory physicians consecutively examined the patients in Ghent University Hospital from October 2004 till October 2006. This study was based on the demographic characteristics, upper and lower airway conditions.
Forty-seven percent of the patients included in the study were males and the mean age of studied population was 43.6 years. The major complaint was chronic cough. When present, patients with chronic cough have an increased risk of suffering from a concomitant asthma in both allergic rhinitis (OR=5.8) and CRS with nasal polyps (OR=10.4), but not in CRS without polyps.
Chronic cough was found to be a key symptom of associated asthma in allergic rhinitis and CRS with nasal polyps. Interestingly, chronic cough in CRS without nasal polyps did not show the same predictive value: this suggests different pathophysiological mechanisms.
上、下呼吸道之间的流行病学、病理生理学和临床联系如今已得到明确证实。大多数哮喘患者同时患有鼻炎，而多达 40%的鼻炎患者患有哮喘。哮喘患者和 COPD 患者也容易同时发生慢性鼻-鼻窦炎（CRS）。本研究旨在确定咳嗽对同时患有上气道疾病的哮喘患者的预测价值。
本横断面研究描述了一组 143 例同时患有常见上、下气道疾病的连续患者。耳鼻喉科专家和呼吸内科医生于 2004 年 10 月至 2006 年 10 月在根特大学医院连续对这些患者进行检查。本研究基于人口统计学特征、上、下气道状况。
研究中纳入的患者 47%为男性，研究人群的平均年龄为 43.6 岁。主要症状是慢性咳嗽。当存在慢性咳嗽时，患有过敏性鼻炎（OR=5.8）和伴有鼻息肉的 CRS（OR=10.4）的患者发生同时存在哮喘的风险增加，但不伴有鼻息肉的 CRS 则无此风险。
在过敏性鼻炎和伴有鼻息肉的 CRS 中，慢性咳嗽被发现是哮喘相关的关键症状。有趣的是，不伴有鼻息肉的 CRS 中的慢性咳嗽没有显示出相同的预测价值：这表明存在不同的病理生理机制。
