Niimi Akio
Nihon Rinsho. 2016 Oct;74(10):1693-1697.
Cough variant asthma (CVA), a phenotype of asthma solely presenting with coughing, is the most common cause of chronic cough in Japan, which lasts for 8 weeks or longer. It shares some clinical and pathophysiological features with classic asthma with wheezing such as seasonal or nocturnal coughing, airway hyperresponsiveness, eosinophilic airway inflammation and airway remodeling. The key diagnostic feature of CVA is the responsiveness of coughing to bronchodilators (beta-agonists), but the mainstay treatment after the established diagnosis is the long-term treatment with inhaled corticosteroids with or without other controller antiasthma medica- tions. Progression of CVA to classic asthma could be prevented with an early introduction of inhaled corticosteroids. Treatment of concomitant gastroesophageal reflux disease, which/ often coexists with CVA, may be considered in intractable cases.
咳嗽变异性哮喘(CVA)是哮喘的一种仅表现为咳嗽的类型,是日本慢性咳嗽最常见的原因,慢性咳嗽持续8周或更长时间。它与伴有喘息的典型哮喘具有一些临床和病理生理特征,如季节性或夜间咳嗽、气道高反应性、嗜酸性气道炎症和气道重塑。CVA的关键诊断特征是咳嗽对支气管扩张剂(β受体激动剂)有反应,但确诊后的主要治疗方法是长期使用吸入性糖皮质激素,可联合或不联合其他控制哮喘的药物。早期使用吸入性糖皮质激素可预防CVA进展为典型哮喘。对于难治性病例,可考虑治疗常与CVA共存的胃食管反流病。