成人咳嗽变异性哮喘62例误诊分析

Adult Cough Variant Asthma Misdiagnosis of 62 Cases

目的:分析咳嗽变异性哮喘(CVA)的误诊原因,加深对该病的认识,提高诊断水平,避免误诊误治。方法:总结62例误诊患者临床资料,对误诊原因进行分析。结果:成人咳嗽变异性哮喘以慢性咳嗽为主要或唯一表现,无明显肺部阳性体征,症状不典型,临床极易误诊误治。本组164例确诊患者中,误诊62例,误诊率达37.8%,其中,误诊为急慢性支气管炎29例(46.77%),上呼吸道感染12例(19.36%),慢性咽炎12例(19.36%),支原体肺炎5例(8.06%),过敏性鼻炎3例(4.84%),支气管内膜结核1例(1.61%)。结论:造成误诊主要原因是对该病认识不足、病史采集不详细、对成人患病情况重视不够、缺乏必要的辅助检查、滥用抗生素及止咳化痰药以及临床思维局限,对病情缺乏全面分析等。应提高对该病的认识,减少误诊。

Objective：Analysis of cough variant asthma （CVA） of the misdiagnosis,to deepen understanding of the disease,improve diagnosis and avoid misdiagnosis.Methods：62 patients with clinical information on the causes of misdiagnsis.Results：Adult cough variant asthma with chronic cough as the main or only performance, no significant lung positive signs,symptoms not typical of clinical misdiagnosis easily. 164 eases in this group of patients diagnosed 62 cases of misdiagnosis,misdiagnusis rate was 37.8%,which was misdiagnosed as acute and chronic bronchitis in 29 cases（46,77%）,upper respiratory tract infection in 12 cases （19.36%）,chronic pharyngitis, 12 cases （19.36%）,Mycoplasma pneumonia,5 cases （8.06%）,allergic rhinitis in 3 cases （4.84%）,endobronchial tuberculosis in 1 case （1.61%）.Conelusion：Msdiagnosed mainly because lack of knowledge of the disease,history taking is not detailed enough attention to the prevalence in adults,lack the necessary laboratory examinations,the abuse of antibiotics and cough and phlegm medicine and clinical thinking,lack of comprehensive analysis of the condition.Should raise awareness of the disease,reduce misdiagnosis.