Sacha R F, Tremblay N F, Jacobs R L
Ann Allergy. 1985 Mar;54(3):195-8.
Ten patients, aged 7 to 16 years, were prospectively evaluated for chronic cough of more than 4 months duration. All patients denied wheezing, but in addition to cough complained of chronic obstructive nasal symptoms. Sinus roentgenograms were consistent with sinusitis in 7/10 patients. Methacholine bronchial provocation was positive in 6/9 patients. The patients were recalled for a 2-year follow-up evaluation. Of seven follow-up patients, bronchial asthma had developed in three, two patients had chronic cough and exercise-induced bronchospasm, and two patients had chronic cough without wheezing. Methacholine bronchial provocation was positive in 6/6 patients. Sinus roentgenograms were compatible with sinusitis in 4/7 patients. Chronic cough in some children may be a complaint of diffuse hyperreactive airways complicated by sinusitis. In some of the children the clinical course evolved into a diffuse respiratory tract disorder including chronic obstructive eosinophilic rhinitis, recurrent or chronic sinusitis and bronchial asthma. An IgE-mediated mechanism usually could not be shown in the pathogenesis.
对10名年龄在7至16岁之间的患者进行了前瞻性评估，这些患者患有持续超过4个月的慢性咳嗽。所有患者均否认有喘息，但除咳嗽外还伴有慢性阻塞性鼻症状。鼻窦X光片显示7/10的患者符合鼻窦炎表现。9名患者中6名的乙酰甲胆碱支气管激发试验呈阳性。对这些患者进行了为期2年的随访评估。在7名接受随访的患者中，3名发展为支气管哮喘，2名患有慢性咳嗽和运动诱发性支气管痉挛，2名患有无喘息的慢性咳嗽。6/6的患者乙酰甲胆碱支气管激发试验呈阳性。7名患者中4名的鼻窦X光片符合鼻窦炎表现。一些儿童的慢性咳嗽可能是弥漫性气道高反应性并伴有鼻窦炎的表现。在一些儿童中，临床病程演变为弥漫性呼吸道疾病，包括慢性阻塞性嗜酸性粒细胞性鼻炎、复发性或慢性鼻窦炎以及支气管哮喘。在发病机制中通常无法显示IgE介导的机制。
