Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland.
Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Banacha 1A, 02-097, Warsaw, Poland.
Eur Arch Otorhinolaryngol. 2020 Oct;277(10):2753-2759. doi: 10.1007/s00405-020-06071-y. Epub 2020 May 27.
Upper airway cough syndrome (UACS), described as chronic cough (CC) associated with allergic (AR), non-allergic rhinitis (NAR) or chronic rhinosinusitis (CRS), is one of the major causes of CC. We aimed to characterize a cohort of UACS patients with special attention to differences between patients with AR and NAR.
A prospective analysis of clinical data of patients, diagnosed with UACS between 2015 and 2018.
There were 143 patients diagnosed with UACS, median age 52 years, women predominance (68.5%), The group comprised of 59 (41%) AR and 84 (59%) NAR subjects, CRS diagnosed in 17 (12%). Median cough duration: 48 months (IQR 24-120), median cough severity (VAS)-60 mm (IQR 42-78), median Leicester Cough Questionnaire (LCQ) score-11.3 (IQR 8.7-13.7), never-smokers: 70%. The most common symptoms: PND (62%), rhinorrhea (59%), nasal congestion (54%), abnormalities of sinus CT: septum deviation (62%), turbinates hypertrophy (53%), mucosal thickening (53%). UACS as the only cause of CC, was presented in 20 patients (14%). We found no differences between patients with AR and NAR in terms of age, gender, duration and severity of cough, BMI, blood eosinophil count, total IgE and FeNO. AR was associated with higher comorbidity of asthma than NAR (54% vs 35%, p = 0.019). Abnormalities in sinus CT scan were more frequently found in patients with NAR than AR (p = 0.018).
NAR is the most common upper airway disease associated with UACS. Clinical characteristics of UACS patients with AR and NAR are similar with only minor differences between these groups. It seems reasonable to plan further studies concerning relationship of NAR and cough sensitivity, also in terms of potential similar neurogenic mechanism.
上气道咳嗽综合征（UACS）被描述为与变应性（AR）、非变应性鼻炎（NAR）或慢性鼻-鼻窦炎（CRS）相关的慢性咳嗽（CC），是 CC 的主要原因之一。我们旨在对 UACS 患者的队列进行特征描述，特别注意 AR 与 NAR 患者之间的差异。
对 2015 年至 2018 年间诊断为 UACS 的患者的临床数据进行前瞻性分析。
共诊断出 143 例 UACS 患者，中位年龄 52 岁，女性占主导地位（68.5%），其中 59 例（41%）为 AR，84 例（59%）为 NAR，17 例（12%）诊断为 CRS。中位咳嗽持续时间：48 个月（IQR 24-120），中位咳嗽严重程度（VAS）-60mm（IQR 42-78），中位莱斯特咳嗽问卷（LCQ）评分-11.3（IQR 8.7-13.7），从不吸烟者占 70%。最常见的症状：PND（62%）、流涕（59%）、鼻塞（54%）、鼻窦 CT 异常：鼻中隔偏曲（62%）、鼻甲肥大（53%）、黏膜增厚（53%）。UACS 作为 CC 的唯一原因，在 20 例患者（14%）中表现出来。我们发现 AR 和 NAR 患者在年龄、性别、咳嗽持续时间和严重程度、BMI、血嗜酸性粒细胞计数、总 IgE 和 FeNO 方面无差异。与 NAR 相比，AR 患者哮喘合并症更多（54% vs 35%，p=0.019）。NAR 患者鼻窦 CT 扫描异常较 AR 患者更常见（p=0.018）。
NAR 是最常见的与 UACS 相关的上气道疾病。AR 和 NAR 的 UACS 患者的临床特征相似，两组之间只有细微差异。似乎有理由进一步研究 NAR 与咳嗽敏感性之间的关系，也可以从潜在的相似神经机制方面进行研究。
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