Traister Russell S, Fajt Merritt L, Petrov Andrej A
Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Allergy Asthma Proc. 2016 Mar-Apr;37(2):25-31. doi: 10.2500/aap.2016.37.3936.
Vocal cord dysfunction (VCD) is frequently misdiagnosed and mistreated as asthma, which leads to morbidity secondary to unnecessary medication use and increased health care utilization.
We identified discriminating symptoms and triggers, and analyzed the costs, morbidity, and health care burden associated with misdiagnosis of VCD as asthma. We sought to determine if current measures of asthma control contributed to these findings. We evaluated if a simple set of breathing exercises would be an effective low-cost treatment option for those with VCD.
We compared the demographics, comorbidities, clinical symptoms, and symptom triggers of subjects with VCD misdiagnosed as asthma compared with those not misdiagnosed as asthma. Costs secondary to asthma misdiagnosis were quantified, and the effectiveness of breathing exercises as a treatment option was evaluated.
We identified symptoms of shortness of breath, wheezing, chest tightness, and a trigger of exercise as being more common in the subjects with VCD misdiagnosed as asthma. Asthma medication use and health care utilization and costs were also higher in this group. The subjects with VCD had Asthma Control Questionnaire scores that labelled them as having uncontrolled asthma. Breathing exercises appeared to offer an inexpensive and effective treatment option for subjects with VCD.
Misdiagnosis of VCD as asthma leads to significant morbidity and increased costs, and misuse of measures of asthma control may be contributing to these findings. Timely and accurate diagnosis of VCD and the use of breathing exercises have the potential to eliminate or minimize the burdens on the patient and the health care system.
声带功能障碍（VCD）常被误诊为哮喘并接受不当治疗，这会导致因不必要的药物使用而引发的发病率上升以及医疗保健利用率增加。
我们确定了鉴别性症状和触发因素，并分析了将VCD误诊为哮喘所带来的成本、发病率和医疗保健负担。我们试图确定当前的哮喘控制措施是否导致了这些结果。我们评估了一套简单的呼吸练习对于VCD患者是否是一种有效的低成本治疗选择。
我们比较了被误诊为哮喘的VCD患者与未被误诊为哮喘的患者的人口统计学特征、合并症、临床症状和症状触发因素。对因哮喘误诊产生的成本进行了量化，并评估了呼吸练习作为一种治疗选择的有效性。
我们发现呼吸急促、喘息、胸闷症状以及运动触发因素在被误诊为哮喘的VCD患者中更为常见。该组患者的哮喘药物使用、医疗保健利用率和成本也更高。VCD患者的哮喘控制问卷得分表明他们患有未得到控制的哮喘。呼吸练习似乎为VCD患者提供了一种廉价且有效的治疗选择。
将VCD误诊为哮喘会导致显著的发病率和成本增加，而哮喘控制措施的误用可能是造成这些结果的原因。及时准确地诊断VCD并使用呼吸练习有可能消除或减轻患者和医疗保健系统的负担。
