School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, England.
Department of Physiological Sciences, University of Florida, Gainesville, FL.
Chest. 2021 Jan;159(1):282-293. doi: 10.1016/j.chest.2020.08.2086. Epub 2020 Sep 2.
The purpose of this state-of-the-art review is to update the American College of Chest Physicians 2006 guideline on global physiology and pathophysiology of cough. A review of the literature was conducted using PubMed and MEDLINE databases from 1951 to 2019 and using prespecified search terms. We describe the basic phenomenology of cough patterns, behaviors, and morphological features. We update the understanding of mechanical and physiological characteristics of cough, adding a contemporary view of the types of cough and their associated behaviors and sensations. New information about acoustic characteristics is presented, and recent insights into cough triggers and the patient cough hypersensitivity phenotype are explored. Lastly, because the clinical assessment of patients largely focuses on the duration rather than morphological features of cough, we review the morphological features of cough that can be measured in the clinic. This is the first of a two-part update to the American College of Chest Physicians 2006 cough guideline; it provides a more global consideration of cough phenomenology, beyond simply the mechanical aspects of a cough. A greater understanding of the typical features of cough, and their variations, may allow a more informed interpretation of cough measurements and the clinical relevance for patients.
本综述旨在更新美国胸科医师学会 2006 年关于咳嗽的全球生理学和病理生理学指南。通过使用 PubMed 和 MEDLINE 数据库，从 1951 年到 2019 年，使用预设的搜索词，我们对文献进行了回顾。我们描述了咳嗽模式、行为和形态特征的基本现象学。我们更新了对咳嗽力学和生理学特征的理解，增加了对咳嗽类型及其相关行为和感觉的当代观点。我们介绍了有关声学特征的新信息，并探讨了咳嗽诱因和患者咳嗽高敏表型的最新见解。最后，由于临床对患者的评估主要集中在咳嗽的持续时间上，而不是咳嗽的形态特征上，我们回顾了可以在临床上测量的咳嗽的形态特征。这是对美国胸科医师学会 2006 年咳嗽指南的两部分更新中的第一部分；它提供了对咳嗽现象学的更全面的考虑，不仅仅是咳嗽的力学方面。更好地了解咳嗽的典型特征及其变化，可能有助于更深入地理解咳嗽测量值以及对患者的临床意义。
