【摘要】 目的分析慢性咳嗽患者的病因诊断和特异性治疗的效果。方法采用中华医学会呼吸病学分会制订的《咳嗽的诊断与治疗指南》中慢性咳嗽病因诊断流程,在询问病史和体格检查的基础上,对106例慢性咳嗽患者进行常规胸部X线、肺功能和气道反应性、鼻窦X线或CT、24h食管pH监测、诱导痰细胞分类等检查,根据临床表现、检查结果及特异性治疗的反应确定病因诊断。结果106例慢性咳嗽患者中,101例(95.3%)诊断明确,单一病因咳嗽者81例(80.2%),复合病因者20例(19.8%)。其中咳嗽变异性哮喘(CVA)66例(62.3%),鼻后滴漏综合征(PNDs)15例(14.1%),胃食管反流性咳嗽(GERC)11例(10.4%),感染后咳嗽(PIC)4例(3.8%),血管紧张素转换酶抑制剂(ACEI)类药物诱导的药物性咳嗽3例(2.8%),嗜酸性粒细胞性支气管炎(EB)2例(1.9%),病因未明5例(4.7%)。经特异性治疗后92例(91.1%)患者咳嗽得到控制,9例(8.9%)咳嗽部分缓解。结论CVA、PNDs、GER是慢性咳嗽的主要病因,大部分患者经特异性治疗后咳嗽症状消失。更多还原

【Abstract】 Objective To analyze the etiological diagnosis and efficacy of specific therapy of chronic cough.Methods Totally 106 patients with chronic cough were diagnosed using a diagnostic protocol based on the Guideline on Diagnosis and Treatment of Chronic Cough established by China Medical Association,which included history inquiry,physical examination,pulmonary function tests,X-ray or CT of paranasal sinuses or chest,24-hour esophageal pH monitoring,and sputum cell differentials.The etiological diagnosis was made according to clinical manifestations,examination results,and response to specific therapy.Results The cause of chronic cough was confirmed in 101 patients(95.3%).Cough due to a single cause was found in 81 patients(80.2%),and due to multiple causes in 20 patients(19.8%).The causes included cough variant asthma(CVA) in 66 patients(62.3%),postnasal drip syndrome(PNDs) in 15 patients(14.1%),gastroesophageal reflux(GERC) in 11 patients(10.4%),post-infection cough(PIC) in 4 patients(3.8%),angiotensin converting enzyme inhibitor(ACEI) induction in 3 patients(2.8%),and eosinophilic bronchitis(EB) in 2 patients(1.9%).Five patients(4.7%) had not been definitely diagnosed.After specific therapy based on diagnosis,cough disappeared in 92 patients(91.1%) and alleviated in 9 patients(8.9%).Conclusions CVA,PNDs,and GERC are the most common causes of chronic cough.Specific therapy based on definite cause can result in good outcome.更多还原