不明原因慢性咳嗽的诊断与治疗

Diagnosis and treatment of chronic cough with unknown causes

目的研究慢性咳嗽的病因对病因实施治疗的有效率。方法91例慢性咳嗽患者按解剖学诊断程序+诱导痰细胞学分类进行病因诊断,针对病因实施特异性治疗。结果病因诊断率为90%(82/91),病因未明10%(9/91),其中咳嗽变异性哮喘占31%(29/91),病毒感染后咳嗽占18%(17/91)。82例明确诊断经针对性治疗有效率93.3%(77/82)。结论慢性咳嗽解剖性咳嗽患者病因明确,针对性治疗有效。

Objective To explore the spectrum and frequency of causes of chronic cough among Chinese patients. Methods The diagnosis procedure was based on the anatomical protocol for diagnosing chronic cough designed by Irvin and additional cytological assay was performed for sputum. The efficacy of therapy was evaluated. Results Ninety-one patients with chronic cough were enrolled in the study. Definite diagnosis was made in 82 （90%） out of the 91 patients. The most common causes included cough variant asthma （29/91, 31% ）, cough after virus infection （17/91 ; 18% ）, eosinophilic bronchitis （13/91, 14% ）, postnasal drip syndrome （7/91 ; 8% ） and gastro esophageal reflux （4/91; 5% ）. After active management based on the diagnosis, cough symptoms improved in 77 patients （93.3%）. Conclusion A positive response to the soecific therapy is essential to the definite diagnosis.