[基层医疗中的慢性持续性咳嗽:2年期间329例患者的诊断与治疗]
[Chronic persistent cough in general practice: diagnosis and therapy in 329 patients over the course of 2 years].
作者信息
Kardos P, Gebhardt T
机构信息
Gemeinschaftspraxis und Pneumologische Belegabteilung Maingau-Krankenhaus, Frankfurt/Main.
出版信息
Pneumologie. 1996 Jun;50(6):437-41.
Chronic Cough: Chronic persistent cough (CPC) lasting from several months to years - without radiographic or spirometric evidence of its cause - was a surprisingly frequent reason (5,7% of all new referrals) to consult our practice. Sophisticated diagnostic evaluation and therapeutic regimen are necessary. We performed a prospective study on 329 consecutive patients (106 male, 223 female) over a two-year period. 65% of the patients had cough as a consequence of bronchial hyperresponsiveness; 27% due to upper airways disease, i.e. often very common rhinitis or pharyngitis; 14% chronic bronchitis; 5% gastrooesophageal reflux (GER); 3% drug induced cough; 4% other causes. 10% of the patients discontinued the diagnostic evaluation prematurely. In 14% the cause for CPC remained unclear and no relief could be achieved. Furthermore, there is a need for consecutive studies to address the following questions: 1. The cause of the striking difference in gender (male : female = 1 : 2) remains unclear. 2. Wether a cough recorder - as occasionally reported in the literature - is needed for an objective evaluation of cough [9]. 3. A standardised methodology of 24 h pH monitoring for the diagnosis of CPC as a consequence of GER has yet to be established.
慢性咳嗽
慢性持续性咳嗽(CPC)持续数月至数年,且无影像学或肺功能检查证据显示其病因,是前来我们诊所就诊的一个出人意料的常见原因(占所有新转诊患者的5.7%)。需要进行复杂的诊断评估和治疗方案。我们在两年时间里对329例连续患者(106例男性,223例女性)进行了一项前瞻性研究。65%的患者咳嗽是由支气管高反应性引起的;27%是由于上呼吸道疾病,即通常非常常见的鼻炎或咽炎;14%是慢性支气管炎;5%是胃食管反流(GER);3%是药物性咳嗽;4%是其他原因。10%的患者过早中断了诊断评估。14%的患者CPC的病因仍不清楚,无法缓解。此外,需要进行连续研究以解决以下问题:1. 性别差异显著(男性:女性 = 1:2)的原因尚不清楚。2. 是否需要如文献中偶尔报道的咳嗽记录仪来客观评估咳嗽[9]。3. 用于诊断因GER导致的CPC的24小时pH监测的标准化方法尚未建立。