Madison J Mark, Irwin Richard S
Division of Pulmonary, Allergy and Critical Care Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA.
Otolaryngol Clin North Am. 2010 Feb;43(1):1-13, vii. doi: 10.1016/j.otc.2009.11.001.
Cough is a common and important respiratory symptom that can produce significant complications for patients and be a diagnostic challenge for physicians. An organized approach to evaluating cough begins with classifying it as acute, subacute, or chronic in duration. Acute cough lasting less than 3 weeks may indicate an acute underlying cardiorespiratory disorder but is most commonly caused by a self-limited viral upper respiratory tract infection (eg, common cold). Subacute cough lasting 3 to 8 weeks commonly has a postinfectious origin; among the causes, Bordetella pertussis infection should be included in the differential diagnosis. Chronic cough lasts longer than 8 weeks. When a patient is a nonsmoker, is not taking an angiotensin-converting enzyme inhibitor, and has a normal or near-normal chest radiograph, chronic cough is most commonly caused by upper airway cough syndrome, asthma, nonasthmatic eosinophilic bronchitis, or gastroesophageal reflux disease alone or in combination.
咳嗽是一种常见且重要的呼吸道症状，它会给患者带来严重并发症，对医生来说也是一项诊断挑战。评估咳嗽的系统方法首先是根据持续时间将其分类为急性、亚急性或慢性。持续时间少于3周的急性咳嗽可能提示潜在的急性心肺疾病，但最常见的原因是自限性病毒性上呼吸道感染（如普通感冒）。持续3至8周的亚急性咳嗽通常源于感染后；在其病因中，百日咳博德特氏菌感染应列入鉴别诊断。慢性咳嗽持续时间超过8周。当患者不吸烟、未服用血管紧张素转换酶抑制剂且胸部X光片正常或接近正常时，慢性咳嗽最常见的原因是上气道咳嗽综合征、哮喘、非哮喘性嗜酸性粒细胞性支气管炎或胃食管反流病，可为单一病因或多种病因共同作用。
