咳型哮喘的临床特点及预后研究

The Clinical Characteristic and Prognostic Research of Cough Variant Asthma

目的随着人们认识的加深及检查方法的普及,被诊断为咳型哮喘的病人逐年增多,因此,有必要认识该病的一些特征及预后.方法对155例成人CVA患者进行2 a的动态观察,并复查乙酰甲胆碱激发试验做前后对比分析.结果男女比率为1:4,平均年龄(40±7.2)岁,共有20例转为典型哮喘,占12.94%;2 a后复查了乙酰甲胆碱激发试验70%为阳性,乙酰甲胆碱浓度与气道高反应性呈负相关;FEV1%与CVA病情程度呈负相关;30%的初选患者未按规律用药而脱落.结论CVA为中青年女性多发,多有明显诱因,女性患者较男性预后差,规律用药普遍预后较好;患者的依从性是防治的难点;对于久咳不愈的年轻女性应高度重视CVA;乙酰甲胆碱浓度、FEV1%可作为评判CVA病情程度及其预后的有效指标;大部分CVA患者(70%)气道高反应状态长期存在,可能是其转为典型哮喘最有意义的危险因素之一,应追踪、防治.

Objective As we know more about CVA and examination methods are becoming more popular, the number of patients diagnosed as CVA is increasing year after year. So it is necessary that we should find more clinical characteristic and therapy for CVA. Methods 155 CVA patients have been observed for 2 years and the results of bronchial methacholine chloride provocation test before and after the observation were analyzed. Results 30% of the patients werent analyzed because they did not take the drugs regularly. The result showed that the CVA male vs female was 1 ： 4, the average age was （40±7.2） years. 20 patients developed typical asthma （ 12. 94% ） . After 2 years, 70% of the patients had positive results of the bronchial methacholine chloride provocation. Methacholine chloride concentration was negatively related to hyperresponsiveness of bronchus. FEV1% was negatively related to the state of asthmatic degree. Conclusions The CVA was incident to the young and the middle - age females, often with an obvious inducement . The female prognosis was worse than that of the male. Generally speaking, the prognosis was good if patients took medicine regularly. Patientscompliance was the essence of the prevention and the cure. Young females who had chronic cough indicate CVA. The concentration of methacholine chloride and FEV1% were effective indexes when we estimated the state and prognosis of CVA. In most CVA patients, the hyperresponsiveness stayed for a long time, which maybe one of the most dangerous risks. We should keep on observing and treating those patients.