King's College London, Division of Asthma, Allergy and Lung Biology, Denmark Hill, London SE5 9RS, UK.
Am J Respir Crit Care Med. 2011 Mar 15;183(6):708-15. doi: 10.1164/rccm.201007-1017CI. Epub 2010 Dec 10.
Chronic cough that cannot be explained after basic evaluation is a common reason for patients to be referred to respiratory outpatient clinics. Asthma, gastroesophageal reflux, and upper airway disorders frequently coexist with chronic cough. There is some controversy as to whether these conditions are causes or aggravants of cough. Heightened cough reflex sensitivity is an important feature in most patients. There is good evidence that it is reversible when associated with upper respiratory tract infection, angiotensin-converting enzyme inhibitor medications, and chronic cough associated with eosinophilic airway inflammation. In many patients, heightened cough reflex sensitivity is persistent and their cough is unexplained. There are few therapeutic options for patients with unexplained chronic cough. There is a pressing need to understand the genetic, molecular, and physiological basis of unexplained chronic cough and to develop novel antitussive drugs that down-regulate cough reflex sensitivity.
在基本评估后仍无法解释的慢性咳嗽是患者被转介到呼吸门诊的常见原因。哮喘、胃食管反流和上气道疾病常与慢性咳嗽并存。这些情况是咳嗽的原因还是加重因素存在一些争议。咳嗽反射敏感性增高是大多数患者的一个重要特征。有充分的证据表明，咳嗽反射敏感性增高与上呼吸道感染、血管紧张素转换酶抑制剂药物以及与嗜酸性气道炎症相关的慢性咳嗽有关时是可以逆转的。在许多患者中，咳嗽反射敏感性持续增高，而他们的咳嗽无法解释。对于不明原因的慢性咳嗽患者，治疗选择很少。迫切需要了解不明原因慢性咳嗽的遗传、分子和生理基础，并开发新型镇咳药物以降低咳嗽反射敏感性。
