慢性咳嗽伴有支气管激发试验阳性患者的临床特征

Clinical characteristics of chronic cough associated with bronchial provocation test positive

目的分析慢性咳嗽伴有支气管激发试验阳性患者的临床特征性表现。方法对符合纳入标准的2008年7月至2010年8月就诊的710例慢性咳嗽患者记录临床特征,进行组胺激发试验。结果在支气管激发试验阳性的慢性咳嗽患者中,夜间咳重、咳痰、咳嗽时有轻度喘鸣、有变应性鼻炎史、咳嗽影响睡眠、遇冷喷嚏、流涕的构成比显著高于支气管激发试验阴性的患者(P值均<0.05);而白天咳重的构成比显著低于支气管激发试验阴性的患者(P=0.03)。Logistic回归分析发现:变应性鼻炎(OR=1.611,P=0.012)、遇冷喷嚏、流涕(OR=1.601,P=0.006)、咳嗽影响夜眠(OR=1.658,P=0.003)是激发试验阳性的危险因素。结论慢性咳嗽伴有支气管激发试验阳性患者的一些临床特征的构成比与对照组有显著差异;咳嗽影响夜眠、变应性鼻炎和遇冷喷嚏、流涕是慢性咳嗽患者出现支气管激发试验阳性的危险因素。

Objective To explore the clinical characteristics of chronic cough associated with bronchial provocation test positive. Methods Seven hundred and ten patients with chronic cough between July 2008 and August 2010 were evaluated. They met the inclusion criteria. The clinical characteristics of chronic cough were recorded. The histamine challenge tests were carried out. Results Compared with the patients with bronchial provocation test negative, the constituent ratio of nocturnal cough, expectoration, mild wheezing, allergic rhinitis, cough disturbing sleep, cold sneezing and runny nose were significantly higher（all P 〈0.05） in the patients with bronchial provocation test positive, the constituent ratio of nocturnal cough were significantly lower （P = 0.03） in the patients with bronchial provocation test positive. On Logistic regression analysis, the following factors were independently with provocation test positive., allergic rhinitis （ OR = 1. 611, P = 0. 012）, cold sneezing and runny nose （ OR = 1. 601, P=0. 006） ,cough disturbing sleep （ OR = 1. 658, P =0. 003）. Conclusions There are significantly difference of some clinic features between the patients with provocation test positive and nagtive. Allergic rhinitis, cold sneezing and runny nose, cough disturbing sleep are independent risk factors of provocation test positive in the chronic cough patients.