咳嗽变异性哮喘：临床特征、诊断及病理生理学综述
Cough-Variant Asthma: A Review of Clinical Characteristics, Diagnosis, and Pathophysiology.
作者信息
Cox Joshua K, Lockey Richard, Cardet Juan Carlos
机构信息
Division of Allergy and Immunology, University of South Florida, Tampa, Fla.
Division of Allergy and Immunology, University of South Florida, Tampa, Fla.
出版信息
J Allergy Clin Immunol Pract. 2025 Mar;13(3):490-498. doi: 10.1016/j.jaip.2024.11.005. Epub 2024 Nov 16.
Abstract
Chronic cough is among the most common symptoms prompting medical care. Cough-variant asthma (CVA) is an asthma subset where cough is the primary symptom, without wheezing, chest tightness, or dyspnea. It is an important cause of chronic cough, estimated to account for 25% to 42% of cases, but likely underdiagnosed due to delayed recognition and pitfalls of diagnostic testing. Early recognition and treatment can reduce morbidity and delay its progression to more typical asthma. This review details the clinical characteristics, diagnosis, pathophysiology, and treatment of CVA and contrasts it with classic asthma and other causes of chronic cough.
摘要
慢性咳嗽是促使就医的最常见症状之一。咳嗽变异性哮喘（CVA）是哮喘的一个亚型，其主要症状为咳嗽，无喘息、胸闷或呼吸困难。它是慢性咳嗽的一个重要原因，估计占病例的25%至42%，但由于诊断延迟和诊断测试的缺陷，可能未得到充分诊断。早期识别和治疗可降低发病率，并延缓其发展为更典型的哮喘。本文综述详细介绍了咳嗽变异性哮喘的临床特征、诊断、病理生理学和治疗，并将其与经典哮喘和其他慢性咳嗽原因进行了对比。
相似文献
1
Cough-Variant Asthma: A Review of Clinical Characteristics, Diagnosis, and Pathophysiology.咳嗽变异性哮喘：临床特征、诊断及病理生理学综述
J Allergy Clin Immunol Pract. 2025 Mar;13(3):490-498. doi: 10.1016/j.jaip.2024.11.005. Epub 2024 Nov 16.
2
[Pathogenesis and clinical features of nonasthmatic eosinophilic bronchitis].非哮喘性嗜酸性粒细胞性支气管炎的发病机制与临床特征
Pneumonol Alergol Pol. 2007;75(4):389-93.
3
Demographics, risk factors and prevalence of chronic cough in Asian general adult population: a narrative review.亚洲普通成年人群中慢性咳嗽的人口统计学、危险因素及患病率：一项叙述性综述。
J Thorac Dis. 2025 May 30;17(5):3419-3432. doi: 10.21037/jtd-24-248. Epub 2025 May 27.
4
Eosinophilic airway disorders associated with chronic cough.与慢性咳嗽相关的嗜酸性气道疾病
Pulm Pharmacol Ther. 2009 Apr;22(2):114-20. doi: 10.1016/j.pupt.2008.12.001. Epub 2008 Dec 16.
5
Surveillance for Violent Deaths - National Violent Death Reporting System, 50 States, the District of Columbia, and Puerto Rico, 2022.暴力死亡监测——2022年全国暴力死亡报告系统，50个州、哥伦比亚特区和波多黎各
MMWR Surveill Summ. 2025 Jun 12;74(5):1-42. doi: 10.15585/mmwr.ss7405a1.
6
Electronic cigarettes for smoking cessation.用于戒烟的电子烟。
Cochrane Database Syst Rev. 2025 Jan 29;1(1):CD010216. doi: 10.1002/14651858.CD010216.pub9.
7
Electronic cigarettes for smoking cessation.电子烟戒烟。
Cochrane Database Syst Rev. 2024 Jan 8;1(1):CD010216. doi: 10.1002/14651858.CD010216.pub8.
8
Comparison of airway inflammation characteristics detected by lower exhaled nitric oxide in cough variant asthma, non-asthmatic eosinophilic bronchitis, and classic asthma.呼出气一氧化氮检测咳嗽变异性哮喘、非哮喘性嗜酸性粒细胞性支气管炎和典型哮喘气道炎症特征的比较
J Asthma. 2025 May;62(5):807-816. doi: 10.1080/02770903.2024.2444319. Epub 2025 Jan 8.
9
Airway inflammation, bronchial hyperresponsiveness, and anti-asthma therapy responses in cough variant asthma and classic asthma with FEV% ≥80% predicted.预测FEV%≥80%的咳嗽变异性哮喘和典型哮喘患者的气道炎症、支气管高反应性及抗哮喘治疗反应。
BMC Pulm Med. 2025 Apr 9;25(1):166. doi: 10.1186/s12890-025-03627-8.
10
Assessing the comparative effects of interventions in COPD: a tutorial on network meta-analysis for clinicians.评估慢性阻塞性肺疾病干预措施的比较效果：面向临床医生的网状Meta分析教程
Respir Res. 2024 Dec 21;25(1):438. doi: 10.1186/s12931-024-03056-x.
引用本文的文献
1
Persistent cough due to cough variant asthma following upper respiratory tract infection treated by traditional Chinese medicine: A case report.中医药治疗上呼吸道感染后咳嗽变异性哮喘所致持续性咳嗽：一例报告
Medicine (Baltimore). 2025 Aug 22;104(34):e43957. doi: 10.1097/MD.0000000000043957.
2
Efficacy and safety of Suhuang Zhike capsule for cough variant asthma: a multicenter, single-arm, open-label phase IV real-world clinical trial.苏黄止咳胶囊治疗咳嗽变异性哮喘的疗效与安全性：一项多中心、单臂、开放标签的IV期真实世界临床试验
J Tradit Chin Med. 2025 Aug;45(4):817-828. doi: 10.19852/j.cnki.jtcm.2025.04.011.
本文引用的文献
1
Sputum Metabolomic Signature and Dynamic Change of Cough Variant Asthma.咳嗽变异性哮喘的痰液代谢组学特征及动态变化
Am J Respir Cell Mol Biol. 2025 Mar;72(3):285-296. doi: 10.1165/rcmb.2024-0219OC.
2
An efficacy and safety evaluation of montelukast + fluticasone propionate vs. fluticasone propionate in the treatment of cough variant asthma in children: a meta-analysis.孟鲁司特钠+丙酸氟替卡松与丙酸氟替卡松治疗儿童咳嗽变异性哮喘的疗效和安全性评价：一项荟萃分析。
BMC Pulm Med. 2023 Dec 5;23(1):489. doi: 10.1186/s12890-023-02721-z.
3
Efficacy and safety of montelukast adjuvant therapy in adults with cough variant asthma: A systematic review and meta-analysis.孟鲁司特辅助治疗成人咳嗽变异性哮喘的疗效和安全性：系统评价和荟萃分析。
Clin Respir J. 2023 Oct;17(10):986-997. doi: 10.1111/crj.13629. Epub 2023 May 22.
4
Identification of cough-variant asthma phenotypes based on clinical and pathophysiologic data.基于临床和病理生理学数据识别咳嗽变异性哮喘表型。
J Allergy Clin Immunol. 2023 Sep;152(3):622-632. doi: 10.1016/j.jaci.2023.04.017. Epub 2023 May 11.
5
Tiotropium for refractory cough in asthma via cough reflex sensitivity: A randomized, parallel, open-label trial.噻托溴铵治疗哮喘难治性咳嗽通过咳嗽反射敏感性：一项随机、平行、开放标签试验。
Ann Allergy Asthma Immunol. 2023 Jul;131(1):59-68.e3. doi: 10.1016/j.anai.2023.03.032. Epub 2023 Apr 7.
6
Executive summary: Japanese guidelines for adult asthma (JGL) 2021.执行摘要：《2021年日本成人哮喘指南》
Allergol Int. 2023 Apr;72(2):207-226. doi: 10.1016/j.alit.2023.02.006. Epub 2023 Mar 22.
7
Airway hyperresponsiveness reflects corticosteroid-sensitive mast cell involvement across asthma phenotypes.气道高反应性反映了跨哮喘表型的皮质类固醇敏感肥大细胞的参与。
J Allergy Clin Immunol. 2023 Jul;152(1):107-116.e4. doi: 10.1016/j.jaci.2023.03.001. Epub 2023 Mar 10.
8
Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update.2022 年全球哮喘倡议（GINA）更新：初级保健的主要建议。
NPJ Prim Care Respir Med. 2023 Feb 8;33(1):7. doi: 10.1038/s41533-023-00330-1.
9
Prediction of bronchodilation test in adults with chronic cough suspected of cough variant asthma.疑似咳嗽变异性哮喘的慢性咳嗽成年患者支气管舒张试验的预测
Front Med (Lausanne). 2022 Dec 9;9:987887. doi: 10.3389/fmed.2022.987887. eCollection 2022.
10
Study on the Relationship Between Bronchoalveolar Lavage Fluid Cell Count, Th1/Th2 Cytokines and Pulmonary Function in Patients with Cough Variant Asthma.咳嗽变异性哮喘患者支气管肺泡灌洗液细胞计数、Th1/Th2细胞因子与肺功能的关系研究
J Asthma Allergy. 2022 Nov 24;15:1713-1720. doi: 10.2147/JAA.S383128. eCollection 2022.
Zotero 插件